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Acalculous cholecystitis in Crohn's disease
J S Hyams1, E Baker, A N Schwartz
1Department of Pediatrics, Hartford Hospital, CT 06115-0729.
Insights
Crohn
Area of Science:
- Gastroenterology
- Pediatric Surgery
Background:
- Crohn's ileocolitis can present with gallbladder enlargement.
- Distinguishing between hydrops and acalculous cholecystitis (AAC) is crucial.
Observation:
- A 15-year-old boy with Crohn's ileocolitis had gallbladder enlargement.
- Ultrasound suggested hydrops or AAC; laparotomy revealed a gangrenous gallbladder.
Findings:
- Diagnostic modalities for gallbladder enlargement in Crohn's disease are reviewed.
- Failure to differentiate hydrops from AAC can lead to severe outcomes.
Implications:
- Early and accurate diagnosis of gallbladder pathology in pediatric Crohn's disease is vital.
- Prompt surgical intervention may be necessary for life-threatening AAC.
Abstract:
A 15-year-old boy with Crohn's ileocolitis developed marked gallbladder enlargement. Ultrasonographic findings were consistent with acalculous cholecystitis (AAC) or hydrops. At laparotomy a gangrenous gallbladder was found. The diagnostic modalities currently used to distinguish between hydrops, a benign condition generally treated expectantly, and AAC, a potentially life-threatening condition requiring surgical treatment are reviewed. Failure to distinguish between these two conditions with acalculous gallbladder enlargement and similar clinical and radiologic features may have serious consequences.