Calcium carbonate gallstones in children

Mark D. Stringer, Roger D. Soloway, Donald R. Taylor, Kallingal Riyad, Giles Toogood

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: In the United States, cholesterol stones account for 70% to 95% of adult gallstones and black pigment stones for most of the remainder. Calcium carbonate stones are exceptionally rare. A previous analysis of a small number of pediatric gallstones from the north of England showed a remarkably high prevalence of calcium carbonate stones. The aims of this study were to analyze a much larger series of pediatric gallstones from our region and to compare their chemical composition with a series of adult gallstones from the same geographic area. Methods: A consecutive series of gallbladder stones from 63 children and 50 adults from the north of England were analyzed in detail using Fourier transform infrared microspectroscopy. Demographic and clinical data were collected on all patients. The relative proportions of each major stone component were assessed: cholesterol, protein and calcium salts of bilirubin, fatty acids, calcium carbonate, and hydroxyapatite. Results: Thirty-nine (78%) adults had typical cholesterol stones, 7 (14%) had black pigment bilirubinate stones, and only 2 (4%) had calcium carbonate stones. In contrast, 30 (48%) children had black pigment stones, 13 (21%) had cholesterol stones, 15 (24%) had calcium carbonate stones, 3 (5%) had protein dominant stones, and 2 (3%) had brown pigment stones. In children, cholesterol stones were more likely in overweight adolescent girls with a family history of gallstones, whereas black pigment stones were equally common in boys and girls and associated with hemolysis, parenteral nutrition, and neonatal abdominal surgery. Calcium carbonate stones were more common in boys, and almost half had undergone neonatal abdominal surgery and/or required neonatal intensive care. Conclusion: The composition of pediatric gallstones differs significantly from that found in adults. In particular, one quarter of the children in this series had calcium carbonate stones, previously considered rare. Geographic differences are not the major reason for the high prevalence of calcium carbonate gallstones in children.

Original languageEnglish (US)
Pages (from-to)1677-1682
Number of pages6
JournalJournal of Pediatric Surgery
Volume42
Issue number10
DOIs
StatePublished - Oct 2007

Fingerprint

Calcium Carbonate
Gallstones
Cholesterol
Pediatrics
England
Neonatal Intensive Care
Parenteral Nutrition
Fourier Analysis
Durapatite
Hemolysis
Gallbladder
Bilirubin
Proteins
Fatty Acids
Demography

Keywords

  • Calcium carbonate
  • Gallbladder
  • Gallstones

ASJC Scopus subject areas

  • Surgery

Cite this

Stringer, M. D., Soloway, R. D., Taylor, D. R., Riyad, K., & Toogood, G. (2007). Calcium carbonate gallstones in children. Journal of Pediatric Surgery, 42(10), 1677-1682. https://doi.org/10.1016/j.jpedsurg.2007.05.022

Calcium carbonate gallstones in children. / Stringer, Mark D.; Soloway, Roger D.; Taylor, Donald R.; Riyad, Kallingal; Toogood, Giles.

In: Journal of Pediatric Surgery, Vol. 42, No. 10, 10.2007, p. 1677-1682.

Research output: Contribution to journalArticle

Stringer, MD, Soloway, RD, Taylor, DR, Riyad, K & Toogood, G 2007, 'Calcium carbonate gallstones in children', Journal of Pediatric Surgery, vol. 42, no. 10, pp. 1677-1682. https://doi.org/10.1016/j.jpedsurg.2007.05.022
Stringer MD, Soloway RD, Taylor DR, Riyad K, Toogood G. Calcium carbonate gallstones in children. Journal of Pediatric Surgery. 2007 Oct;42(10):1677-1682. https://doi.org/10.1016/j.jpedsurg.2007.05.022
Stringer, Mark D. ; Soloway, Roger D. ; Taylor, Donald R. ; Riyad, Kallingal ; Toogood, Giles. / Calcium carbonate gallstones in children. In: Journal of Pediatric Surgery. 2007 ; Vol. 42, No. 10. pp. 1677-1682.
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