Related Experiment Video
Updated: Mar 2, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Risk factors for poor outcomes of children with acute acalculous cholecystitis
Yi-An Lu1, Cheng-Hsun Chiu2, Man-Shan Kong1
1Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Insights
Acute acalculous cholecystitis (AAC) in children can be severe. Key predictors of mortality include anemia, thrombocytopenia, gallbladder sludge, hepatitis, and sepsis with hepatitis, aiding early risk identification.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Critical Care Medicine
Background:
- Acute acalculous cholecystitis (AAC) in children is often underestimated but can lead to fatal outcomes.
- Early identification of risk factors is crucial for managing pediatric AAC.
Purpose of the Study:
- To present the clinical features of pediatric AAC.
- To identify predictors of mortality in children diagnosed with AAC.
Main Methods:
- Retrospective study of 147 pediatric AAC patients (2005-2012).
- AAC defined by fever and thickened gallbladder wall (>4 mm) on ultrasound.
- Mortality predictors identified via association analyses and multivariate logistic regression.
Main Results:
- Common presentations: elevated C-reactive protein (84%), hepatomegaly (80%), anorexia (78%).
- Associated conditions: infectious diseases (70%), systemic diseases (13%), malignancy (11%).
- Mortality rate was 9.25% (14/147); predictors included anemia, thrombocytopenia, gallbladder sludge, hepatitis, and sepsis plus hepatitis.
Conclusions:
- Anemia, thrombocytopenia, gallbladder sludge, hepatitis, and sepsis with hepatitis are significant predictors of mortality in pediatric AAC.
- These findings assist clinicians in identifying high-risk patients for timely intervention and improved prognoses.
Background:
Acute acalculous cholecystitis (AAC) is generally considered to be a mild disease in children; however, if left untreated or treated without caution, AAC can lead to severe outcomes, such as death. The objectives of this study were to present the clinical features and identify the predictors of mortality in pediatric AAC.
Methods:
Patients diagnosed with AAC between 2005 and 2012 were enrolled. AAC was defined by the presence of fever and an echo-proven thickened gallbladder wall exceeding 4 mm. A poor health outcome was defined as death. Further information related to the demographics, clinical manifestations, laboratory results, ultrasound findings, and pathogens present in the AAC patients was also collected. Predictors of mortality were identified by association analyses and confirmed by multivariate logistic regression.
Results:
A total of 147 pediatric AAC patients (male/female = 1.01, mean age = 5.2 years) were included in this retrospective study. The most common clinical presentation was an elevated C-reactive protein level (84%) followed by hepatomegaly (80%) and anorexia (78%). AAC in children was associated with various diseases, including infectious diseases (70%), systemic diseases (13%), and malignancy (11%). Fourteen of the 147 (9.25%) patients died during the study period. The presences of thrombocytopenia, anemia, gallbladder sludge, hepatitis, and/or sepsis plus hepatitis were found to be the important predictors of AAC mortality.
Conclusions:
The factors associated with AAC mortality were anemia, thrombocytopenia, gallbladder sludge, hepatitis, and sepsis plus hepatitis. These predictors are likely to help clinicians identify patients who are at a high risk of poor prognoses and make appropriate clinical decisions.
More Related Videos
03:27The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
Published on: January 31, 2025
07:48Intraoperative Video Consultation Following Bile Duct Transection Facilitates Direct OR Transfer for Robotic Hepaticojejunostomy at Tertiary Center
Published on: January 9, 2026
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment: