From Prof Mohammed Ezz El Regal بتعملوا ايه فى الحالات دى الاجابه 👇👇👇👇👇 Ezz Clinical Pearls – Pediatric Hepatobiliary Topic: Incidentally Detected Gallstones in Children ⸻ 👀 Key Evaluation Steps: 1️⃣. Confirm with proper imaging: • Prefer abdominal ultrasound (look for shadowing, mobility) • Exclude sludge, polyps, or artifacts 2️⃣. Assess symptoms carefully: • Ask about episodic RUQ pain, nausea, vomiting, fat intolerance • Document any history of unexplained abdominal pain 3️⃣. Look for risk factors: • Hemolytic disease (e.g., sickle cell, thalassemia) • Obesity, rapid weight loss • Total parenteral nutrition • Medications (e.g., ceftriaxone, octreotide) • Family history or metabolic/genetic disorders ⸻ Management Depends on Symptoms: 1️⃣. Asymptomatic: ✅• Observe and monitor ✅• Lifestyle & diet optimization ✅• Follow-up ultrasound every 6–12 months 2️⃣. Mild biliary symptoms : | ✅ Refer to pediatric gastroenterologist ✅ Consider elective cholecystectomy 3️⃣. Complications: (cholangitis, pancreatitis, obstruction) | ✅ Urgent referral to pediatric surgery ✅ Admit for supportive care & labs ⸻ 🎁 Bonus Clinical Tip: Don’t rush to operate—most asymptomatic children with incidental gallstones do not need surgery unless symptoms or complications arise. ⸻ #ezzclinicalcards #pediatricgi #gallstonesinchildren #hepatobiliarycare #pediatricultrasound #cholelithiasis #drugpearls #gallbladderstone