OBJECTIVES: Determine the treatment of the acalculous acute cholecystitis during the course of typhoid fever in children. MATERIAL AND METHODS: It was carried out a retrospective study in 10 patients with acalculous cholecystitis in the course of typhoid fever, from June 1992 to May 1997, in the Children's Institute of Health. RESULTS: Six patients were male and four women, whose ages fluctuated among the 2 years 6 months old to 15 years old. Cholecystitis was presented mostly in the first weeks of the illness. Characteristic findings were fever, abdominal pain, diarrhea, vomits, jaundice and palpable mass. We have performed cholecystostomy in four patients, cholecystectomy in 3 patients and three patients were not operated, two then received medical treatment and were follow-up with ultrasonography and one patient got lost in the control. The 10 patients received chloramphenicol for 14 days. As post operative complication, a patient presented an intestinal obstruction for adherences and another patient presented an intraabdominal abscess. CONCLUSION: Acute cholecystitis is not a common entity in children, and rare complication in the course of the typhoid fever. The surgical decision is primary in almost all the patients, for the risk of vesicular perforation and the possibility they become healthy carriers. Those patients who were not able to have a surgical treatment, were recommended to have medical treatment and ultrasonographic follow-up.
OBJECTIVES: Determine the treatment of the acalculous acute cholecystitis during the course of typhoid fever in children. MATERIAL AND METHODS: It was carried out a retrospective study in 10 patients with acalculous cholecystitis in the course of typhoid fever, from June 1992 to May 1997, in the Children's Institute of Health. RESULTS: Six patients were male and four women, whose ages fluctuated among the 2 years 6 months old to 15 years old. Cholecystitis was presented mostly in the first weeks of the illness. Characteristic findings were fever, abdominal pain, diarrhea, vomits, jaundice and palpable mass. We have performed cholecystostomy in four patients, cholecystectomy in 3 patients and three patients were not operated, two then received medical treatment and were follow-up with ultrasonography and one patient got lost in the control. The 10 patients received chloramphenicol for 14 days. As post operative complication, a patient presented an intestinal obstruction for adherences and another patient presented an intraabdominal abscess. CONCLUSION: Acute cholecystitis is not a common entity in children, and rare complication in the course of the typhoid fever. The surgical decision is primary in almost all the patients, for the risk of vesicular perforation and the possibility they become healthy carriers. Those patients who were not able to have a surgical treatment, were recommended to have medical treatment and ultrasonographic follow-up.
Authors: Mahendra Singh; Lovekesh Kumar; Rashpal Singh; Aaron K Jain; Snehal K Karande; Arjun Saradna; U Prashanth Journal: Int J Surg Case Rep Date: 2013-12-12