Jaramillo Samaniego J G
Cirujano Pediatra del Instituto de Salud del Niño.
Rev Gastroenterol Peru. 2001 Jan-Mar;21(1):36-41.
Determine the treatment of the acalculous acute cholecystitis during the course of typhoid fever in children.
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.
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.
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.
确定儿童伤寒热病程中无结石性急性胆囊炎的治疗方法。
对1992年6月至1997年5月在儿童健康研究所收治的10例伤寒热病程中患无结石性胆囊炎的患者进行回顾性研究。
6例男性，4例女性，年龄在2岁6个月至15岁之间波动。胆囊炎多在疾病的最初几周出现。特征性表现为发热、腹痛、腹泻、呕吐、黄疸和可触及肿块。我们对4例患者进行了胆囊造瘘术，3例患者进行了胆囊切除术，3例患者未手术，其中2例接受药物治疗并通过超声进行随访，1例患者在随访中失访。10例患者均接受了14天的氯霉素治疗。作为术后并发症，1例患者因粘连出现肠梗阻，另1例患者出现腹腔内脓肿。
急性胆囊炎在儿童中并不常见，是伤寒热病程中的罕见并发症。由于胆囊穿孔的风险以及患者成为健康携带者的可能性，几乎所有患者的首要治疗决策都是手术。对于那些无法接受手术治疗的患者，建议进行药物治疗并超声随访。
