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Diseases of children (pediatrics)

How is chronic cholecystitis treated?

During an exacerbation of chronic cholecystitis, especially with severe pain syndrome, children are hospitalized. Bed rest is prescribed, the duration of which depends on the general condition of the patient. When the exacerbation subsides, taking into account the chronic course of the disease, treatment is carried out on an outpatient basis, for example, in a one-day hospital.

Diagnosis of chronic cholecystitis

Biochemical blood test - during exacerbation of chronic cholecystitis, there is an increase in the content of excretory enzymes (alkaline phosphatase, leucine aminopeptidase, y-glutamyl transpeptidase), a moderate increase in the activity of transaminases.

What causes chronic cholecystitis?

The causes of chronic cholecystitis are not always clear. It is assumed that the disease may be the outcome of acute cholecystitis, but the anamnesis data confirm this assumption only in some children. There are almost always indications of various infectious diseases (chronic tonsillitis, caries, appendicitis, pyelonephritis, intestinal infections, etc.).

Chronic cholecystitis in children

Chronic cholecystitis is an inflammatory-dystrophic disease of the gallbladder with a chronic course and recurrent subacute clinical picture. There are no data on the prevalence of chronic cholecystitis among pediatric patients. In surgical practice, in patients with suspected cholelithiasis, "stone-free" cholecystitis is established in 5-10% of cases.

How is acute cholecystitis treated?

Children with acute cholecystitis are urgently hospitalized. Strict bed rest is prescribed, and observation by a pediatrician, pediatric surgeon, and other specialists is required to determine the treatment tactics.

Diagnosis of acute cholecystitis

Ultrasound allows detecting signs of acute cholecystitis: thickening of the gallbladder walls by more than 3-4 mm, "double" wall contour and increase in organ size, perivesical fluid. Dynamic examination allows judging the form of gallbladder inflammation.

Symptoms of acute cholecystitis

Acute cholecystitis begins suddenly, acutely, often at night with severe pain in the right hypochondrium, epigastric region, less often in other areas of the abdomen (in preschool children). The child is extremely restless, tossing and turning in bed, trying to find a position that alleviates the pain. Nausea and vomiting with bile occur, often multiple and not bringing relief.

What causes acute cholecystitis?

The leading role in the development of acute cholecystitis belongs to infection (E. coli, staphylococcus, streptococcus, proteus, enterococcus, typhoid bacillus). The pathogenetic role of enzymes and proenzymes of the pancreas entering the bile ducts and gall bladder and provoking acute enzymatic cholecystitis is studied.

Acute cholecystitis in children

The leading role in the development of acute cholecystitis belongs to infection (E. coli, staphylococcus, streptococcus, proteus, enterococcus, typhoid bacillus). The pathogenetic role of enzymes and proenzymes of the pancreas entering the bile ducts and gall bladder and provoking acute enzymatic cholecystitis is studied.

How is biliary dyskinesia treated?

Treatment of biliary dyskinesia in children has one goal - restoration of functional disorders of the biliary tract.