Smishchuk V. Clinical and pathogenetic mechanisms of cholelithiasis in children and ways to prevent it

This thesis is devoted to the actual problem of modern pediatrics - improving of diagnosis level of cholelithiasis at the early stages of its formation and effectiveness of preventive measures for children by clarifying the causes and mechanisms of this disease. It is proved that the risk of cholelithiasis in childhood increases under the influence of certain factors: family history burdened by cholelithiasis; early artificial feeding; nutrition (excess of trans fats and omega-6-PUFAs, easy carbohydrates on the background of deficiency of essential phospholipids, omega-3-PUFAs, dietary fiber and probiotic products), which leads to disturbed lipid metabolism of cholesterol, fatty acids and phospholipids and increased frequency of nutritional violations (especially obesity); using of antibiotics and steroid hormones; concomitant diseases of the digestive system (chronic gastroduodenitis, hypokinetic gallbladder combined with spasm of SO, intestinal dysbiosis). If cholelithiasis or gallbladder cholesterosis in children is suspected, taking into account the clinical picture in different periods of childhood, it is recommended to study the blood lipid profile, apply ultrasonic examination of hepatobilliary system with assessment of gallbladder function after choleretic breakfast. Indications for further duodenal intubation with microscopic and biochemical studies of bile are thickening of gallbladder wall more than 3-4 mm and the presence of sludge in its cavity. In case of disorders in blood lipid profile it is reasonable to study content of serum fatty acids and phospholipids for timely use of preventive complex, which includes lecithin, omega-3-PUFAs, probiotics and natural sorbents on the background of nutrition correction.