Mueller Fanny, McDonald Amy, Schellerer Vera S
Department of Pediatric Surgery, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch Straße, 17475, Greifswald, Germany.
Virginia Commonwealth University, College of Health Professions, 900 E Leigh St, Richmond, VA, 23298, USA.
J Med Case Rep. 2025 Feb 23;19(1):67. doi: 10.1186/s13256-025-05066-9.
Although its incidence has increased in recent years, gallbladder inflammation in childhood is generally a rare condition. Acute acalculous cholecystitis accounts for about 50-70% of gallbladder inflammation in childhood, mostly in previously healthy children. The onset is strongly associated with viral, bacterial, or parasitic infections.
We present the case of a healthy 8-year-old boy of German descent diagnosed with necrotic acute acalculous cholecystitis, exhibiting only mild inflammatory signs and an unspecific clinical presentation of abdominal pain. There was no evidence of viral, bacterial, or parasitic infection. According to his unclear clinical presentation with 2-day history of vomiting, we performed an explorative laparoscopy and detected a necrotic gallbladder. After laparoscopic cholecystectomy, the patient's health status improved immediately. He was discharged from the hospital on the third day after the operation.
Unlike our patient, almost all cases of acute acalculous cholecystitis originate from viral or bacterial infections, with clinical evidence of gallbladder inflammation shown on diagnostic imaging. An exploration of the abdominal cavity during a laparoscopic procedure was vital to our patient's mortality and could be for others as well.
尽管近年来其发病率有所上升，但儿童胆囊炎总体上是一种罕见疾病。急性非结石性胆囊炎约占儿童胆囊炎的50%-70%，主要发生在既往健康的儿童中。其发病与病毒、细菌或寄生虫感染密切相关。
我们报告一例8岁健康的德裔男孩，被诊断为坏死性急性非结石性胆囊炎，仅表现出轻微炎症体征和非特异性的腹痛临床表现。没有病毒、细菌或寄生虫感染的证据。根据其有2天呕吐病史的不明确临床表现，我们进行了探索性腹腔镜检查，发现胆囊坏死。腹腔镜胆囊切除术后，患者的健康状况立即改善。他在术后第三天出院。
与我们的患者不同，几乎所有急性非结石性胆囊炎病例都源于病毒或细菌感染，诊断性影像学检查显示有胆囊炎症的临床证据。腹腔镜手术期间对腹腔进行探查对我们患者的预后至关重要，对其他患者也可能如此。
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