[The occurrence of gallbladder contractility disorders in children with some diseases presenting as abdominal pain]

Abstract

Gallbladder dyskinesia is not mentioned among current (ROME III) classification of the functional gastrointestinal disorders in children. However both own clinical experience and a few published data spike for the appearance these disturbances also in the developmental age.

Aim of this study: Ultrasound (US) evaluation of gallbladder (GB) contractility in children sick from some diseases presenting as abdominal ailments.

Material and methods: 113 children aged 2-17 yr. (among them 78 with different diseases expressed as upper/middle recurrent abdominal pain and 35 healthy patients, forming the control group) were examined by US (Toshiba SSA-270 and GE Logiq 500 Pro device) to establish their GB activity. Using US, length, width and height of GB were measured, before and after standard fatty meal stimulation. Collected data enabled to count primary volume of GB and to evaluate of its changes, depending on time, which passed since the standard fatty meal, provoking GB activity, has been eaten. The spectrum of co-existing diseases with GB activity disorders was analyzed.

Results: Of 78 examined children with abdominal pains in 67 (86%) GB activity disorders were observed. The average GB volume value was decreased about 36%, in the examined group, whereas the change averaged about 71% in the control study (p < 0.01). From among the 78 of investigated children in 8 (10%) a total lack of GB reaction on the standard meal was stated. In healthy control group only in 4 children (11%) minimal disorders of GB activity were observed (p < 0.001) and none of healthy children has presented GB akinesia. After a year follows-up since the successful basic disease treatment has been applied, ultrasound GB activity examination showed generally improvement, except the cases permanently being obese. From among co-existed diseases most often obesity and other functional disorders as Helicobacter pylori related dyspepsia, constipation and GERD, as well as parasitic diseases and food allergy were notified.

Conclusions: Gallbladder activity disorders might be the origin of abdominal pains during the course of some other diseases and might concern various age including younger children even in kindergarten age. In children, weaken or abolished GB contractility most often co-exists with obesity, many other alimentary functional alimentary disorders, parasitosis and food allergy.