Pediatric Surgery Department. Hospital Universitari Parc Taulí. Sabadell (Spain).
Cir Pediatr. 2023 Oct 1;36(4):186-190. doi: 10.54847/cp.2023.04.15.
In spite of the increase in the prevalence of cholelithiasis in the last decades, no recommendations regarding the best treatment of acute calculous cholecystitis (AC) in Pediatrics have been developed.
4-year-old, 20kg male patient with no significant history referred to our institution as a result of abdominal sepsis. The blood count showed leukocytosis, with normal hemoglobin and bilirubin levels, and a normal liver function. The abdominal ultrasonography revealed cholelithiasis, gallbladder hydrops, and an inflammatory process compatible with appendicular plastron. In the diagnostic laparoscopy, the appendix was macroscopically normal, and acute cholecystitis was observed. Given the patient's situation, and in cooperation with the General Surgery Department, laparoscopic cholecystectomy was carried out. The patient recovered uneventfully on hospitalization day 5 under piperacillin-tazobactam treatment.
There are no recommendations regarding AC treatment in children. In septic patients, cooperation between general and pediatric surgeons allows urgent cholecystectomy to be considered as a safe option.
尽管在过去几十年中胆石症的患病率有所增加，但尚未针对儿科急性胆石性胆囊炎（AC）的最佳治疗方法提出建议。
一名 4 岁、20 公斤的男性患者，无明显病史，因腹部脓毒症被转至我院。血常规显示白细胞增多，血红蛋白和胆红素水平正常，肝功能正常。腹部超声检查显示胆石症、胆囊积水和与阑尾围裙相符的炎症过程。在诊断性腹腔镜检查中，阑尾大体上正常，观察到急性胆囊炎。鉴于患者的情况，并与普通外科合作，进行了腹腔镜胆囊切除术。患者在哌拉西林他唑巴坦治疗下，于住院第 5 天顺利康复。
目前尚无关于儿童 AC 治疗的建议。在脓毒症患者中，普通外科和儿科外科医生的合作可以考虑紧急胆囊切除术作为一种安全的选择。
