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Eosinophilic cholecystitis in children: Case series
Luz Nélida Garzón G1, Lina Eugenia Jaramillo B2, Juan Javier Valero H3
1Universidad Nacional de Colombia, Bogota, Columbia.
Insights
Eosinophilic cholecystitis (EC) is rare in children and always linked to gallstones. Diagnosis is confirmed by histopathology after surgery, with all patients recovering well.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pathology
Background:
- Eosinophilic cholecystitis (EC) is infrequently documented in pediatric patients, with limited case reports compared to adult literature.
- Existing research primarily focuses on adult cases, leaving a gap in understanding EC in children.
Purpose of the Study:
- To comprehensively review the clinical presentation, treatment strategies, and outcomes of pediatric eosinophilic cholecystitis (EC) and lymphoeosinophilic cholecystitis (LEC) cases.
- To characterize the specific features and management of EC in a pediatric hospital setting.
Main Methods:
- Retrospective analysis of cholecystectomy specimens from 2011 to 2017.
- EC defined by >90% eosinophils; LEC defined by 50-90% eosinophils in gallbladder wall.
- Clinical data of patients with EC and LEC were analyzed.
Main Results:
- Eight cases of EC (6.0%) and three of LEC (2.2%) were identified among 134 specimens.
- Patients, with a mean age of 12.6 years, presented with acute cholecystitis and cholelithiasis.
- All patients underwent cholecystectomy, with histopathological confirmation, and recovered without complications.
Conclusions:
- Eosinophilic cholecystitis (EC) is a rare pediatric condition, consistently associated with cholelithiasis.
- EC lacks a distinct clinical presentation and is diagnosed postoperatively via histopathology.
- All pediatric EC cases in this study presented with acute cholecystitis.
Introduction:
Eosinophilic cholecystitis (EC) is rarely seen in the pediatric population. Most of the available literature comes from adult patients, while only anecdotal cases have been reported in children.
Objective:
To describe the clinical course, management, and outcomes of all EC cases treated at a children's hospital.
Material And Methods:
All cholecystectomy specimens obtained between 2011 and 2017 were retrospectively reviewed. EC was diagnosed when more than 90% of the inflammatory cells in the gallbladder wall were eosinophils, whereas lymphoeosinophilic cholecystitis (LEC) was diagnosed when the percentage of eosinophils was between 50 and 90. We analyzed all clinical aspects of patients with EC and LEC.
Results:
We identified and reviewed 134 cholecystectomy specimens. Of them, 8 (6.0%) were classified as EC, and 3 (2.2%) as LEC. The mean age at presentation was 12.6 (2-17) years. The female-to-male ratio was 1.5/1. One patient had a history of hereditary spherocytosis, and 3 patients had systemic eosinophilia. All patients presented with clinical and radiological signs of acute cholecystitis and underwent cholecystectomy. Acute cholecystitis was confirmed by histopathology in all cases. All cases of EC and LEC had cholelithiasis. None of the patients required additional treatment. All patients recovered uneventfully.
Conclusions:
EC is rarely seen in children, it does not have a specific clinical presentation, and it is always associated with cholelithiasis. The diagnosis is made postoperatively by histopathology. All patients in our study presented with acute cholecystitis.
Type Of Study:
Retrospective review.
Level Of Evidence:
Level IV.
