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Outcome of acalculous cholecystitis from typhoid in Nigerian children

Olajide Lukman Abdur-Rahman1, Olaniyi James Adeniran, Adegoke Abdul-Rasheed Nasir

  • 1Pediatric Surgery Unit, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria. bolarjide@yahoo.com

Journal of the National Medical Association
|July 29, 2009
PubMed

Insights

Acalculous typhoid gallbladder perforation is rare but challenging to manage in children. This study highlights the difficulties in treating six pediatric cases with gallbladder complications from typhoid fever.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Gallbladder perforation and gangrene typically result from obstructive cholecystitis, particularly in immunocompromised individuals.
  • While typhoid intestinal perforation is common in tropical regions, gallbladder complications from typhoid are rarely reported.
  • This study focuses on the management challenges of acalculous cholecystitis secondary to typhoid in pediatric patients.

Purpose of the Study:

  • To report and analyze the management of six pediatric cases with gallbladder complications arising from typhoid fever.
  • To highlight the clinical presentation and outcomes of acalculous typhoid cholecystitis in children.

Main Methods:

  • A retrospective review of pediatric surgery and theater records from January 2000 to December 2006.
  • Data collected included patient demographics, clinical presentation, surgical findings, and treatment outcomes.

Main Results:

  • Six patients (5 boys, 1 girl; ages 3-15) presented with septicemia.
  • Three patients had multiple gallbladder perforations, and three had gallbladder gangrene with ileal inflammation.
  • All underwent open cholecystectomy, with one case each of postoperative fecal and biliary fistula; all patients survived.

Conclusions:

  • Acalculous typhoid gallbladder perforation, although uncommon, poses significant management challenges in pediatric patients.
  • Early recognition and surgical intervention are crucial for favorable outcomes in these rare cases.
Abstract

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