Ultrasonic assessment of the prevalence of gall stones in sickle cell disease children seen at the University of Benin Teaching Hospital, Benin City, Nigeria

Abstract

Background: Gallstone is a common problem in patients with sickle cell disease. Prevalence of this problem among sickle cell disease (SCD) children may vary with age, and geographic location. Studies on gallstone
prevalence in SCD children are scanty in the South-South zone of Nigeria.

Aim: To determine by ultrasonography the prevalence of gallstones among steady state sickle cell disease children attending the Paediatric Outpatient Clinic of the University of Benin Teaching Hospital, Benin-City, south south
Nigeria.

Methodology: The study was a descriptive cross sectional study. The prevalence of gall stones was studied prospectively on 101 sickle cell disease patients who attended the Paediatric Outpatient clinic of the University of Benin Teaching Hospital by means of ultrasonography. They were aged 1-18 years. All except three patients were Haemoglobin (Hb) SS
while the remaining three were HbSC. Statistical analysis was done by means, percentages and tests of significance was done using students t- test.

Results: Five of the 101 children studied had gallstones and one had biliary sludge. The prevalence of gallstone was 5%. All patients with gallstones were HbSS, none with HbSC had stone although only three were studied. Only one child was symptomatic for the presence of gallstones. One patient had biliary sludge. The male: female ratio was 4:1. Prevalence
increased with age; 2.9% 4.5% and 9.1% in patients aged less than 5,6-10 and 11-18 years respectively. Body weight was significantly associated with the presence of gallstones.

Conclusion: Gallstone was found in 5% of the SCD children aged 1- 18years. This value is low compared to those from Europe and North America. It however confirmed the relative low prevalence in the general population of Nigerians. The clinical significance of gallstones in these SCD children is that it may contribute significantly to the morbidity and mortality seen in these children.

Recommendation: Routine abdominal scan is recommended for sickle cell disease children to detect gallstone whose presence can mimic abdominal crisis. The option of elective cholecystectomy with reduced morbidity  compared to emergency cholecystectomy can thus be exploited.

Key words: Sickle cell disease, gallstones, biliary, sludge, Benin-City, ultrasound.