The state of the bile ducts in obese children
The growing prevalence of obesity is accompanied by an increased incidence of bile duct disorders in children. The article analyzes current literature data about the pathogenesis, predisposing factors and the clinical picture of hypomotor biliary dysfunction and GID in obese children. Most research works demonstrate an interrelation between obesity and GID. The pathogenesis and predisposing factors of the development of GID differ significantly in different age periods. Cholelithiasis amounts to 1% among diseases of the gastrointestinal tract in the paediatric population, the presence of obesity increases the possibility of the development of GID with a direct correlation between the incidence of GID and the degree of obesity. The leading pathogenetic role in lithogenesis in obese children belongs to insulin resistance, hyperleptinemia, increased cholesterol secretion by the liver and disordered motor function of the gallbladder. The clinical picture does not have characteristic symptoms, sometimes the symptoms are conditioned by gallbladder cholesterosis, but in most cases GID may be asymptomatic. This necessitates early, preferably non-invasive screening diagnosis of these conditions for an early beginning of therapy to prevent severe metabolic disorders, progression of obesity proper and worsening of the quality of life of obese children and adolescents.