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[Acalculous acute cholecystitis during the course of typhoid fever in children]
1Cirujano Pediatra del Instituto de Salud del Niño.
Insights
Acalculous acute cholecystitis is a rare complication of typhoid fever in children. Surgical intervention is often necessary to prevent complications, though medical management with ultrasonography follow-up is an alternative for some patients.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Acalculous acute cholecystitis is an uncommon condition in pediatric patients.
- It is a rare complication that can occur during the course of typhoid fever.
Purpose of the Study:
- To determine the appropriate treatment strategies for acalculous acute cholecystitis in children with typhoid fever.
- To evaluate the outcomes of surgical versus non-surgical management.
Main Methods:
- A retrospective study was conducted on 10 pediatric patients diagnosed with acalculous cholecystitis during typhoid fever.
- Data were collected from June 1992 to May 1997.
Main Results:
- The study included 10 children (6 male, 4 female) aged 2.5 to 15 years.
- Cholecystitis symptoms typically appeared within the first weeks of typhoid fever.
- Treatment involved cholecystostomy (4 patients), cholecystectomy (3 patients), or medical management with ultrasonography (2 patients).
- All patients received a 14-day course of chloramphenicol.
- Post-operative complications included intestinal obstruction and intra-abdominal abscess in one patient each.
Conclusions:
- Surgical intervention is generally recommended for acalculous acute cholecystitis in children with typhoid fever due to risks of gallbladder perforation and potential for becoming healthy carriers.
- For patients unable to undergo surgery, medical treatment and ultrasonographic monitoring are advised.
Objectives:
Determine the treatment of the acalculous acute cholecystitis during the course of typhoid fever in children.
Material And Methods:
It was carried out a retrospective study in 10 patients with acalculous cholecystitis in the course of typhoid fever, from June 1992 to May 1997, in the Children's Institute of Health.
Results:
Six patients were male and four women, whose ages fluctuated among the 2 years 6 months old to 15 years old. Cholecystitis was presented mostly in the first weeks of the illness. Characteristic findings were fever, abdominal pain, diarrhea, vomits, jaundice and palpable mass. We have performed cholecystostomy in four patients, cholecystectomy in 3 patients and three patients were not operated, two then received medical treatment and were follow-up with ultrasonography and one patient got lost in the control. The 10 patients received chloramphenicol for 14 days. As post operative complication, a patient presented an intestinal obstruction for adherences and another patient presented an intraabdominal abscess.
Conclusion:
Acute cholecystitis is not a common entity in children, and rare complication in the course of the typhoid fever. The surgical decision is primary in almost all the patients, for the risk of vesicular perforation and the possibility they become healthy carriers. Those patients who were not able to have a surgical treatment, were recommended to have medical treatment and ultrasonographic follow-up.
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