University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Dr. Tom Colletti, DHSc, MPAS, PA-C



Cholelithiasis is a common cause of abdominal pain in adult patients. Risk factors such as high fat diets and obesity provide strong diagnostic clues when patients present with right upper quadrant pain. Pediatric cholelithiasis is considered rarer but has been increasing in many industrialized countries. These same risk factors as well as hemolytic anemias have been observed in children with cholelithiasis. Autoimmune inflammatory diagnoses have also been assessed as possible risk factors for gallstone development, although primarily within adults, and results have been mixed. Specific conditions like systemic lupus erythematosus (SLE) do occasionally cause acalculus cholecystitis that often occurs later in the disease course. Juvenile idiopathic arthritis (JIA) is an inflammatory condition with multiple subtypes often contributing to joint pain in children. Rheumatoid arthritis has been studied to evaluate the potential increased risk for gallstones, but research involving the contribution of JIA in cholelithiasis in children is severely lacking. Further investigation into this topic would be beneficial to pediatric and emergency providers evaluating children with abdominal pain suggestive of cholelithiasis, especially in the presence of obesity or a known history of JIA. A greater understanding of a potential relationship between these conditions would better equip practitioners to make accurate diagnoses and manage complaints appropriately if cholelithiasis is considered when such risk factors are identified. This case report presents a 12-year-old obese female with JIA diagnosed with gallstones to increase awareness of the growing incidence of pediatric stones and encourage additional research into underlying inflammatory causes.


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