THE SIGNIFICANCE OF BILIARY SLUDGE IN CHILDREN WITH SICKLE-CELL DISEASE

The prevalence of cholelithiasis was studied prospectively by abdomina l ultrasound (US) examination in 305 children with sickle cell disease aged 1-18 years(mean 10.45). Gallstones were present in 60 children ( 19.7%); an additional 50 had biliary sludge only (16.4%). On follow-up of 35 of the 50 children with sludge, 23 (65.7%) had developed gallst ones and 5 had already had a cholecystectomy. Five continued to have s ludge on follow-up while 7 were reported to have no sludge. Children w ith US evidence of sludge should be followed up regularly by US, and t hose who develop gallstones should undergo elective cholecystectomy. F or those with biliary sludge only, we recommend elective cholecystecto my if there are hepatobiliary symptoms.