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September 2005

Patient Data: 5 days old male neonate

Clinical Info: Accidental finding during an ultrasound examination of the kidneys because of a urinary tract infection.

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There is an abnormal gallbladder filled with sludge and small stones causing acoustic shadowing. Sludge and stones can be found in neonates that are on parenteral nutrition. This patient was not on parenteral nutrition. Also reflective material in the gallbladder has been reported during antenatal ultrasound examinations. The reflective material usually disappears after a few gallbladder contractions. This neonate was 5 days old and on normal breast feeding.

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An ultrasound examination performed 2 days later revealed no change. Because the baby was treated with an antibiotic from the cephalosporin group (Claforan = Cefotaxime) a relation between the medication and the material in the gallbladder was suspected. There have been several publications of the effect of Ceftrioxone (also an antibiotic from the Cephalosporin group) and the formation of gallstones.

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A control examination was performed a few days after the treatment of the urinary tract infection with Claforan was completed.

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A control examination was performed a few days after the treatment of the urinary tract infection with Claforan was completed. The gallbladder was now completely normal without any signs of sludge or stones. Diagnosis "Pseudo"cholelithiasis caused by the use of Claforan = Cefotaxime (Cephalosporin group).

9.1.4 Slide 1 shows another case of sludge and stones in the gallbladder. In this case the examination was performed in the search for congenital abnormalities. This child died almost immediately after birth.

For more gallbladder pathology in children see also:

9.1.4 Gallbladder

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