J Korean Med Sci.  2016 Oct;31(10):1617-1623. 10.3346/jkms.2016.31.10.1617.

Age, Predisposing Diseases, and Ultrasonographic Findings in Determining Clinical Outcome of Acute Acalculous Inflammatory Gallbladder Diseases in Children

• Yi DY
• Chang EJ
• Kim JY
• Lee EH
• Yang HR

• KMID: 2468253
• DOI: http://doi.org/10.3346/jkms.2016.31.10.1617

Abstract

We evaluated clinical factors such as age, gender, predisposing diseases and ultrasonographic findings that determine clinical outcome of acute acalculous inflammatory gallbladder diseases in children. The patients were divided into the four age groups. From March 2004 through February 2014, clinical data from 131 children diagnosed as acute acalculous inflammatory gallbladder disease by ultrasonography were retrospectively reviewed. Systemic infectious diseases were the most common etiology of acute inflammatory gallbladder disease in children and were identified in 50 patients (38.2%). Kawasaki disease was the most common predisposing disease (28 patients, 21.4%). The incidence was highest in infancy and lowest in adolescence. The age groups were associated with different predisposing diseases; noninfectious systemic disease was the most common etiology in infancy and early childhood, whereas systemic infectious disease was the most common in middle childhood and adolescence (P = 0.001). Gallbladder wall thickening was more commonly found in malignancy (100%) and systemic infection (94.0%) (P = 0.002), whereas gallbladder distension was more frequent in noninfectious systemic diseases (60%) (P = 0.000). Ascites seen on ultrasonography was associated with a worse clinical course compared with no ascites (77.9% vs. 37.7%, P = 0.030), and the duration of hospitalization was longer in patients with ascites (11.6 ± 10.7 vs. 8.0 ± 6.6 days, P = 0.020). In conclusion, consideration of age and predisposing disease in addition to ultrasonographic gallbladder findings in children suspected of acute acalculous inflammatory gallbladder disease might result in better outcomes.

Keyword

Acute Acalculous Cholecystitis; Gallbladder; Ultrasonography; Age; Clinical Outcome; Child

MeSH Terms

Abdomen/*diagnostic imaging
Acute Disease
Adolescent
Age Factors
Ascites/etiology
Child
Child, Preschool
Female
Gallbladder/*physiopathology
Gallbladder Diseases/*diagnosis/epidemiology
Hospitalization
Humans
Incidence
Length of Stay
Male
Mucocutaneous Lymph Node Syndrome/diagnosis/pathology
Retrospective Studies
Sex Factors
Ultrasonography

Figure

• 

  Fig. 1 Age distribution of pediatric patients with acute acalculous inflammatory gallbladder disease. Acute acalculous gallbladder disease is most prevalent in infants aged ≤ 1 year. The number of patients diagnosed with acute acalculous gallbladder disease is decreasing as age increased.

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