Author
Motil, Kathleen |
Submitted to: Book Chapter
Publication Type: Book / Chapter Publication Acceptance Date: 6/15/2004 Publication Date: 4/1/2006 Citation: Motil, K.J. 2006. Cholecystitis. In: McMillian, J.A., Feigin, R.D., DeAngelis, C.D., Jones, M.D., editors. Oski's Pediatrics: Principles and Practice of Pediatrics. 4th edition. Philadelphia, PA: Lippincott Williams & Wilkins. p. 2042-2045. Interpretive Summary: Technical Abstract: Cholecystitis is an acute or chronic inflammatory disease of the gallbladder that may be classified as calculous or acalculous, based on the presence or absence of gallstones. In developed countries, gallstones occur in 50% to 70% of children who have cholecystitis, but in developing countries, a calculous cholecystitis predominates. Cholecystitis results from three primary events in the gallbladder: bile stasis, an inflammatory response, or ischemia. Although this disorder is less common in children than in adults, its frequency in childhood is increasing. Predisposing factors in children include hemolytic disease, cyclosporine, parenteral nutrition, ileal abnormalities, pregnancy, infections, and a positive family history. The symptoms of cholecystitis in children are similar to those in adults, including abdominal pain and tenderness, vomiting, dietary fat intolerance, and jaundice. Abdominal ultrasonography is the most effective method of identifying gallbladder disease. Laparoscopic cholecystectomy is the treatment of choice for the management of uncomplicated cholecystitis. The prognosis after surgery for children with cholecystitis, but without underlying hemolytic disease, is excellent. |