Abstract
Objective: The aims of this study were to define the etiology, clinical presentation, and prognosis of acute acalculous cholecystitis (AAC) in children.
Methods: Children aged less than 18 years diagnosed with AAC were analyzed retrospectively between 2000 and 2009. The demographic and clinical characteristics, etiology, and outcome were recorded. AAC was defined as GB wall thickness of greater than 3.5 mm and duration of symptoms less than 1 month. The severity of sonographic findings were scored, with 1 point each given for wall thickness greater than 3.5 mm, GB distention, sludge, and pericholecystic fluid.
Results: A total of 109 children (male/female =1.18, mean age = 5.8 years) were diagnosed with AAC. The most common presentation was fever (88%), followed by hepatomegaly (73%) and jaundice (49%). 65% and 72% of patients had thrombocytopenia and elevated alanine aminotransferase, respectively. The common causative etiologies were infectious diseases (58%) and systemic illnesses (27%). In addition to the wall thickening, the most frequent sonographic finding was GB distension (34%), followed by sludge (15%), and pericholecystic fluid (14%). All of our patients were treated non-operatively. Sixteen (15%) patients died. Children with mortality had a significantly higher rate of shock (p< 0.001), anemia (p=0.01), thrombocytopenia (p=0.04), hypofibrinogenemia (p=0.002), presence of pericholecystic fluid, and higher sonographic scores (p=0.04) than those with survival.
Conclusion: Childhood AAC may be secondary to a variety of etiologies, especially during the course of infectious diseases. Presence of shock and a low value of fibrinogen are predictable factors for mortality in childhood AAC.
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Huang, SC., Yang, YJ. 274 Acute Acalculous Cholecystitis in Children: A 10-Year Retrospective Study in a Single Center. Pediatr Res 68 (Suppl 1), 141–142 (2010). https://doi.org/10.1203/00006450-201011001-00274
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DOI: https://doi.org/10.1203/00006450-201011001-00274