Sonographic pattern of gallbladder disease in children with sickle cell anaemia

A prospective analysis of ultrasound examinations of the gallbladder in 161 children with sickle cell anaemia revealed cholelithiasis in 7 cases (4.2%). Biliary sludge was present in 12 cases (7.5%). The commonest abnormality noted was gallbladder wall thickening seen in 13 patients (8.1%). The age range of patients studied was 2 1/2 months to 16 years with a mean of 7.96 years. The youngest age for development of cholelithiasis was 10 years while biliary sludge was noted earliest at 5 years. Gallbladder wall thickening appeared as early as 4 years. Dietary and environmental factors are probably responsible for the low incidence of cholelithiasis in Africans with sickle cell anaemia. The low incidence of cholelithiasis in the African child with this disease does not justify routine and follow-up ultrasound scans in all cases with sickle cell anaemia.