No Longer an Adult Disease

Background: When caring for children, we are all prepared for evaluating abdominal pain as it seems like every condition leads can cause belly pain.

Aim of Paper: To demonstrate that we have to remain vigilant for those subtle presentations of abdominal pain of more omnious conditions.

Material and Method: We present the case of a 8 years girl we arrived to Emergency Room with a 36 hours history of intensive abdominal pain and vomiting. En ER was realized urgent blood tests which revealed hypertransaminasemia and elevated total bilirubin on account of direct bilirubin. The girl had no history of any moment of posible contagion, signs of infection or other sympotms which could explain a frequent etiology of cytolysis in children.

The physical examination revealed an overweight child with an abundante abdominal pannus, with difuse abdominal pain, predominantly in the epigastrum.

We proceed to an abdominal ultrasonography which revealed a gallbladder with multiple stones inside and a discreet dilatation of coledocian.

Due to these findings, we iniciated medical treatment with antibiotics, with improvement of clinical and analitical tests in 24 hours.

Discussions: Cholelithiasis is being recognized in the children with increasing frequency. In children, there may be any number of possible etiologies for the development of gallstones. In the majority, specific etiologic factor is never established. In our case, we suppose the overweight is directly implicated in the produce of gallstones. Differentiating gallbladder disease in children from other causes of abdominal pain can be very difficult, but probably the single most important factor aiding in the diagnosis is simply main.- taining high index of suspicion that it can and does occur in children.

Conclusions: Not all kid belly pain is benign. Think of cholecystitis, even in kids.