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Acute Calculous Cholecystitis Presenting as an Acute Abdomen in a Five-Month-Old Child

Estela Kakoo Brioso1, Joana Jonet2, Sofia M Antunes2

  • 1Pediatrics, Hospital De Cascais Dr. José De Almeida, Lisbon, PRT.

Cureus
|June 24, 2022
PubMed

Insights

Acute cholecystitis, rare in infants, requires consideration for acute abdomen. This case highlights non-surgical management of pediatric gallstone disease, emphasizing prompt therapy to prevent complications.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Surgical Pediatrics

Background:

  • Acute cholecystitis is uncommon in young children, often presenting as an acute abdomen.
  • Early diagnosis and management are crucial to prevent severe complications.

Observation:

  • A five-month-old male presented with crying, poor feeding, vomiting, diarrhea, and right upper quadrant tenderness.
  • Laboratory tests showed elevated gamma-glutamyl transferase and alkaline phosphatase.
  • Abdominal ultrasound suggested acute calculous cholecystitis.

Findings:

  • The patient was successfully treated with intravenous hydration and antibiotics, avoiding surgery.
  • A calcium bilirubinate calculus was found in stool, but the etiology remained undetermined.
  • This case underscores the possibility of gallstone disease in infants.

Implications:

  • Highlights the importance of considering acute cholecystitis in pediatric acute abdomen evaluations.
  • Demonstrates the potential for non-operative management in select pediatric cases.
  • Emphasizes the need for prompt therapeutic intervention to mitigate risks associated with pediatric gallstone disease.

Keywords:
acute abdomenbiliary calculuscalcium bilirrubinate calculuscholecystitispediatrics

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