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September 1, 1978

Ultrasonography, Cholelithiasis, and Sickle Cell Disease

Author Affiliations

Georgetown University Hospital Washington, DC

JAMA. 1978;240(9):829. doi:10.1001/jama.1978.03290090023007

To the Editor.—  Kappelman and Sanders (239:1426, 1978) call attention to the role of ultrasonography in the evaluation of gallbladder disease. We concur with their recommendations and wish to note additional clinical situations in which this diagnostic modality is advisable.While cholelithiasis is uncommon in the pediatric population, we have used ultrasound to diagnose cholelithiasis in children.1 The absence of ionizing radiation makes this procedure particularly attractive in this age group.We have recently diagnosed cholelithiasis in two adult patients with sickle cell disease and suspected acute cholecystitis. The abdominal crisis of sickle cell disease is often difficult to distinguish from gallbladder disease. Oral cholecystograms and intravenous cholangiograms are often not possible because of jaundice. We recommend that patients with sickle cell disease and in particular those with abdominal pain undergo cholecystosonography to establish the presence or absence of gallstones.