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World J Gastroenterol. Nov 21, 2018; 24(43): 4870-4879
Published online Nov 21, 2018. doi: 10.3748/wjg.v24.i43.4870
Acute acalculous cholecystitis in children
Dimitri Poddighe, Vitaliy Sazonov
Dimitri Poddighe, Vitaliy Sazonov, Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Vitaliy Sazonov, Pediatric Intensive Care Unit, UMC National Research Center for Mother and Child Health, Astana 010000, Kazakhstan
Author contributions: Poddighe D conceived and wrote the manuscript; Sazonov V contributed to the literature research and data collection.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dimitri Poddighe, MD, MSc, Assistant Professor, Department of Medicine, School of Medicine, Nazarbayev University, Kerei-Zhanibek Str. 5/1, Astana 010000, Kazakhstan. dimitri.poddighe@nu.edu.kz
Telephone: +7-700-2679413
Received: September 12, 2018
Peer-review started: September 12, 2018
First decision: October 8, 2018
Revised: October 11, 2018
Accepted: October 21, 2018
Article in press: October 21, 2018
Published online: November 21, 2018
Abstract

Acute acalculous cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. AAC is estimated to represent at least 50% to 70% of all cases of acute cholecystitis during childhood. Although this pathology was originally described in critically ill or post-surgical patients, most pediatric cases have been observed during several infectious diseases. In addition to cases caused by bacterial and parasitic infections, most pediatric reports after 2000 described children developing AAC during viral illnesses (such as Epstein-Barr virus and hepatitis A virus infections). Moreover, some pediatric cases have been associated with several underlying chronic diseases and, in particular, with immune-mediated disorders. Here, we review the epidemiological aspects of pediatric AAC, and we discuss etiology, pathophysiology and clinical management, according to the cases reported in the medical literature.

Keywords: Acute acalculous cholecystitis, Children, Viral biliary disorders

Core tip: Acute acalculous cholecystitis (AAC) is the most frequent form of acute cholecystitis in children. In childhood, this disease has been described in critically ill or post-surgical patients, as it often occurs in adults, but most pediatric cases are actually caused by infectious diseases. In addition to bacterial and parasitic infections, most recent pediatric reports have described children developing AAC during viral illnesses, in particular, Epstein-Barr virus and hepatitis A virus infections. Moreover, some pediatric cases have been associated with non-infectious disorders, such as immune-mediated disorders. Therefore, the medical management presents significant differences compared to adult AAC.