A case of acute neonatal acalculous cholecystitis: A case report

Cholecystitis is inflammatory condition of the gallbladder, usually associated with gallstones. It has serious medical complications if left untreated. Both calculous and acalculous cholecystitis are relatively well defined in older children. However, acute acalculous cholecystitis in neonates is exceedingly rare entity and is not well defined in the literature.

We reported a 3-day old, male neonate, weighing 3100 g, born to 26-year-old para II mother at term gestation who brought with the complaint of repeated vomiting of every breast fed for two days. On examination he had deranged vital signs. Abdominal Ultrasound showed features of acute cholecystitis. He had received intravenous fluid and first line antibiotics, improved and discharged after 7 days of hospital stay.

Acute acalculous cholecystitis is the inflammation of the gallbladder. In neonates it commonly occurs in association with sepsis, prematurity, medications and bacterial infections (Escherichia coli) among others. It is also associated with congenital anomalies. Unlike older children neonates present more with variable clinical manifestations and thus the diagnosis may be challenging based on clinical presentation. Moreover, the diagnosis of acalculous cholecystitis is usually obtained through abdominal ultrasonography. The management of acute acalculous neonatal cholecystitis can be conservative and operative.

Even though it is rare, NAC shall be considered in the list of differentials in neonates who presented with features of sepsis and acute abdomen, particularly those with intractable vomiting.