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Acalculous cholecystitis in children

D E Tsakayannis1, H P Kozakewich, C W Lillehei

  • 1Department of Surgery, Children's Hospital, Boston MA 02115, USA.

Journal of Pediatric Surgery
|January 1, 1996
PubMed
Summary
This summary is machine-generated.

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Acalculous cholecystitis in children presents in two forms: acute and chronic. Both forms can be effectively treated with cholecystectomy, though nonoperative management may be suitable for some acute cases.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatobiliary Diseases
  • Surgical Pathology

Background:

  • Acalculous cholecystitis (AC) is a rare pediatric condition with an incompletely understood spectrum.
  • This study retrospectively reviews 25 pediatric AC cases treated between 1970 and 1994.

Purpose of the Study:

  • To delineate the distinct clinical patterns and outcomes of AC in children.
  • To evaluate the efficacy of surgical and non-surgical management strategies for pediatric AC.

Main Methods:

  • Retrospective review of clinical and pathological data for 25 children diagnosed with AC.
  • Classification of AC into acute (<1 month symptom duration) and chronic (>3 months symptom duration) forms.
  • Analysis of presenting symptoms, diagnostic findings (ultrasonography, radionuclide scans), and treatment outcomes.

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Main Results:

  • Two forms identified: acute (13 children) and chronic (12 children).
  • Acute AC predominantly affected males, often post-operative or associated with systemic illness, presenting with fever, RUQ pain, vomiting, and abnormal labs.
  • Chronic AC affected females more, presenting with chronic RUQ pain and nausea, normal labs, and abnormal gallbladder function tests.

Conclusions:

  • Pediatric AC manifests in two distinct acute and chronic patterns, differing in clinical presentation and etiology.
  • Cholecystectomy is an effective treatment for both forms of pediatric AC.
  • Nonoperative management with antibiotics may be a viable option for select cases of acute AC.