Acute acalculous cholecystitis: report of a case in a four year old boy and review of the literature

ABSTRACT

The presence of acalculous cholecystitis in pediatric patients is rare, although the incidence of this condition is higher in children than adults. Predisposing factors are frequently present, including systemic infection, [Salmonella, E. coli, Pseudomonas, ...] trauma, major operations, anatomical derangements, dehydration, and third-degree burns, parasitic infestation with ascaris or Giardia lamblia. Clinical features include right upper quadrant or epigastric pain, nausea, vomiting, fever and sometimes jaundice. Right upper quadrant guarding and tenderness are present. The clinical and laboratory diagnosis of acute acalculous cholecystitis is difficult and the reliability of various diagnostic imaging techniques has not been established. However, sonography and C.T. scan seem to be highly sensitive [62% and 100% respectively,] and specific [96% and 100% respectively]. The diagnosis is confirmed at laparotomy. Cholecystectomy and treatment of the systemic infection are required. A four-year old boy with acute acalculous cholecystitis is reported. In this case giardiasis was a predisposing factor, cholecystectomy and treatment of giardiasis were performed