Journal List > J Korean Assoc Pediatr Surg > v.20(2) > 1071948

Kim, Lim, and Lee: Biliary Pseudolithiasis in Children: To Avoid Unnecessary Surgical Procedure

Abstract

Gallbladder stones in children are not common without underlying hemolytic diseases or other risk factors like obesity. Ceftriaxone, a third generation cephalosporin, is known to make biliary precipitations that can be mistaken for biliary stones. We here report two children with biliary pseudolithiasis with different treatment modalities. One child was mistaken for symptomatic gallbladder stones and underwent elective laparoscopic cholecystectomy, while the other child, after thorough history taking on the ceftriaxone medication, was suspected of biliary pseudolithiasis and was treated conservatively. Both children had the history of usage of ceftriaxone in previous hospitals for infectious diseases. The ceftriaxone history of the first child was missed before the surgery. When gallbladder stones are found in children without any underlying diseases, specific history taking of the usage of ceftriaxone seems to be absolutely required. In this case, immediate interruption of the antibiotic could resolve the episode and avoid unnecessary surgical procedure.

Figures and Tables

Fig. 1
CT shows multiple gallbladder stones (case 1).
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Fig. 2
Ultrasonography performed at the emergency room shows multiple gallbladder sandy stones with sludge (case 2).
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Fig. 3
Ultrasonography after 6 weeks of conservative treatment shows the disappearance of previous gallbladder stones (case 2).
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Notes

No potential conflict of interest relevant to this article was reported.

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