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

Journal of the Korean Association of Pediatric Surgeons 2014; 20(2): 62-64.

Published online: 30 December 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.2.62

Biliary Pseudolithiasis in Children: To Avoid Unnecessary Surgical Procedure

Shinn Young Kim1, Soo-Ah Lim2, Myung Duk Lee1

1Division of Pediatric Surgery, Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.

2Department of Diagnostic Radiology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.

Correspondence: Myung Duk Lee, Division of Pediatric Surgery, Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, 222, Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-6092, Fax: +82-2-595-2822, myungdlee@gmail.com

Received 12 September 2014       Revised 3 November 2014       Accepted 11 November 2014

Copyright © 2014 by the Korean Association of Pediatric Surgeons

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Ceftriaxone, Biliary pseudolithiasis, Child

Figures and Tables

Fig. 1
CT shows multiple gallbladder stones (case 1).
jkaps-20-62-g001
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).
jkaps-20-62-g003

Notes

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

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