Cholecystitis among pediatric population attending at a tertiary care hospital
Cholecystitis in children
Keywords:Cholecystitis, Paediatric population, Pathophysiologic pattern, Abdominal ultrasound
Background: In recent years, an increasing trend of paediatric cholecystitis is noticed in literature along with changing spectrum of biliary tract disease.
Objectives: The study was aimed to evaluate pediatric cholecystitis pointing on its underappreciated but important aetio-athophysiological reasons and pattern.
Methods: This prospective type of observational study was done from November 2019 to April 2020 among a total of 65 children of acute and chronic cholecystitis (clinical manifestation not ≥72hours -acute; and for ≥6months with ≥3episodes-chronic). Data were collected on socio-demographic and clinical findings, laboratory results and image (abdominal ultrasound, and HIDA scan) findings, along with operative and histopathological (postoperative) findings.
Results: The mean age of the patients was 8.35 years, with male/female=1.17 and 48(73.8%) were from low socioeconomic condition. Preoperatively, 42 (64.6%) patients were presented with acute cholecystitis and 23 (53.6%) were with chronic cholecystitis with the commonest symptom of upper abdominal colicky pain 57 (87.6%.) and sign of right upper quadrant tenderness 65(100.0%) in both cases. On image findings, presence of pericholecystic fluid with biliary sludge was the major finding 27 (64.0%) and then gall stone 12 (29.0%) in
acute cholecystitis whereas in chronic cholecystitis, the commonest finding was, fibrosis of gallbladder wall 12 (52.0%) and then gallstone 8 (35.0%). All patients were treated operatively(open cholecystectomy=35 (22.8%), laparoscopic =30 (19.5%). Post-operatively, in acute cases, thickened gallbladder wall was the major finding 29 (69.0%), but in chronic cases, fibrosis of gallbladder wall was the commonest 13 (57.0%) finding. Total 37 (56.4%) patients among 65 had found an association between cholecystitis and prior infestation of diseases pathogens (typhoid enteritis 10 (15.4%) was the commonest).The type of infestation was not independent with the type of cholecystitis but a relationship between two was present (p=0.5671).
Conclusion: Acute acalculous cholecystitis with biliary sludge accounts for the majority of paediatric cholecystitis and there was an association between paediatric cholecystitis with prior infestation of disease pathogens.
Bangladesh Med Res Counc Bull 2021; 47(3): 295-301
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Copyright (c) 2022 Nirupama Saha, Sajal Kumar Majumdar, Mirza Kamrul Zahid, Writtika Majumdar, Md Samsuzzaman Khan, Abdullah Al-Mamun, Rajib Dey Sarker
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