Risk factors for poor outcomes of children with acute acalculous cholecystitis

Lu, Yi‐An; Chiu, Cheng-Hsun; Kong, Man‐Shan; Wang, Han‐I; Chao, Hsun‐Chin; Chen, Chien‐Chang

doi:10.1016/j.pedneo.2016.12.005

Cited by 14 publications

(17 citation statements)

References 26 publications

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“…None of the parameters were useful for diagnosing AAC. These findings confirmed the observation that AAC was concomitant with acute hepatitis rather than being induced by intrahepatic cholestasis . The correlation between the C‐reactive protein concentration in the blood and the severity of acute cholecytitis is a well‐known observation in adult patients, and several studies reported that the CRP value was a reliable predictor of severe conditions of inflammation and should be used in Tokyo classification .…”

Section: Discussionsupporting

confidence: 83%

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Mazur‐Melewska¹,

Derwich²,

Mania³

et al. 2019

Int J Clin Pract

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Background Acute acalculous cholecystitis (AAC), an inflammatory process of the gallbladder (GB) in the absence of gallstones, typically occurs in seriously ill patients. AAC can complicate primary Epstein‐Barr virus (EBV) infection, but it is an atypical clinical presentation. Aim The aim of our study was to analyse AAC occurrence in children with primary symptomatic EBV infection who had been admitted to the hospital. Methods We retrospectively evaluated the medical documentation of 181 children with EBV infection who were diagnosed based on the presence of viral capsid antigen IgM antibodies. All EBV‐positive patients underwent transabdominal ultrasonography of the liver in the supine and right anterior oblique positions. Fifteen children who presented with AAC symptoms, including abdominal pain and a positive Murphy's sign, were analysed as a subsample and re‐evaluated after 2‐3 months. Results The incidence of AAC in children hospitalised with infectious mononucleosis (IM) was estimated at 8.3%. Analysis of the laboratory results confirmed that the C‐reactive protein (CRP) concentration was the only parameter which was higher in children who presented with AAC symptoms. The mean number of leucocytes and monocytes and liver enzyme activities were not significantly higher. The radiological findings of AAC were evident: increased GB wall thickness, non‐shadowing echogenic sludge and pericholecystic fluid collection. Conclusion AAC during primary EBV infection appears to be a more common pathology than previously suspected. Its relatively mild nature and the lack of laboratory abnormalities mean that ultrasonographic examination is required for diagnosis. This might explain why the prevalence in children is underestimated.

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Section: Discussionsupporting

confidence: 83%

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Mazur‐Melewska¹,

Derwich²,

Mania³

et al. 2019

Int J Clin Pract

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“…Only one case was observed during an enteroviral infection. Recently, Lu et al 4 presented similar results in a review of 147 paediatric patients. AAC was associated with various illnesses, including infectious diseases (70%), systemic diseases (13%) and malignancy (11%).…”

Section: Discussionmentioning

confidence: 62%

“…Viral pathogens were found in 54 patients, mostly Epstein-Barr virus (32, 22%) and cytomegalovirus (10, 7%). No case of AAC associated with enterovirus was reported 4…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, bile stasis may alter chemical bile composition and promote gallbladder mucosal injury 3. The pathogenesis of AAC in the course of viral infection is unclear and could result from this complexity of factors (effect of proinflammatory mediators, reperfusion injury, cholestasis, etc) 4…”

Section: Discussionmentioning

confidence: 99%

“…However, it is the most frequent form of acute cholecystitis in this age group, representing 30% to 70% cases 1–3. In adults, AAC causes only 2% to 15% of acute cholecystitis cases 4…”

Section: Introductionmentioning

confidence: 99%

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Acalculous acute cholecystitis during the course of an enteroviral infection

Simões¹,

Marinhas²,

Coelho³

et al. 2019

BMJ Case Rep

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Gallbladder diseases are uncommon in children. Acalculous acute cholecystitis, although rare, is the most frequent form of acute cholecystitis in childhood. In acalculous acute cholecystitis, clinical presentation and laboratory findings are unspecific, making the diagnosis challenging. Abdominal ultrasonography is the first-line exam. Most cases of paediatric acalculous acute cholecystitis have been described in critically ill patients, but can occur in previously healthy children, without underlying diseases or severe conditions. The authors present a clinical report of a child with acalculous acute cholecystitis and enteroviral infection. Diagnosis, treatment, clinical course and prognosis are described. Pathophysiology, aetiology, diagnosis and treatment of acalculous acute cholecystitis are also discussed.

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Congenital Absence of the Common Bile Duct - A Rare Anomaly with an Evolving Association with Esophageal Atresia

Elmously

Saluja

Rosenbaum

et al. 2018

Journal of Pediatric Surgery Case Reports

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Risk factors for poor outcomes of children with acute acalculous cholecystitis

Abstract: The factors associated with AAC mortality were anemia, thrombocytopenia, gallbladder sludge, hepatitis, and sepsis plus hepatitis. These predictors are likely to help clinicians identify patients who are at a high risk of poor prognoses and make appropriate clinical decisions.

Cited by 14 publications

References 26 publications

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Epstein‐Barr virus infection with acute acalculous cholecystitis in previously healthy children

Acalculous acute cholecystitis during the course of an enteroviral infection

Congenital Absence of the Common Bile Duct - A Rare Anomaly with an Evolving Association with Esophageal Atresia

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