Synchronous Acute Appendicitis and Cholecystitis in a Paediatric Patient with Salmonella Enteritis

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Gastroenterology

Background:

• Cholecystitis and appendicitis are common surgical conditions, but rarely occur simultaneously.
• Pediatric presentations of cholecystitis are uncommon, often mimicking other abdominal pathologies.
• Travel history can be crucial in diagnosing infectious gastroenteritis in children.

Observation:

• A 13-year-old male presented with right upper quadrant pain and diarrhea after traveling from Bali.
• Elevated C-reactive protein (CRP) and normal white cell count were noted.
• Diagnostic laparoscopy revealed inflammation in both the gallbladder and appendix.

Findings:

• Histopathology confirmed both cholecystitis and appendicitis.
• Stool culture identified Salmonella serotype B as the causative agent.
• This represents the first reported pediatric case of synchronous cholecystitis and appendicitis.

Implications:

• Surgeons should consider rare diagnoses like synchronous cholecystitis and appendicitis in pediatric patients, especially those with atypical symptoms or recent travel history.
• Salmonella infection can present with unusual gastrointestinal manifestations requiring prompt surgical and microbiological evaluation.
• Awareness of this rare co-occurrence is vital for accurate diagnosis and timely surgical intervention in pediatric cases.