Diseases of children (pediatrics)

How is chronic cholecystitis treated?

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

Diagnosis of chronic cholecystitis

Biochemical blood test - with exacerbation of chronic cholecystitis, the content of excretory enzymes (alkaline phosphatase, leucine aminopeptidase, y-glutamyltranspeptidase) increases, 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 can be the outcome of acute cholecystitis, but the anamnesis confirms this assumption only in some children. Almost always there are 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 chronic course and recurrent subacute clinical picture. Data on the prevalence of chronic cholecystitis among patients of childhood are absent. In surgical practice, patients with suspicion of cholelithiasis in 5-10% of cases are established "acuminate" cholecystitis.

How is acute cholecystitis treated?

Children with acute cholecystitis are urgently hospitalized. Assign a strict bed rest, supervision of a pediatrician, a pediatric surgeon and other specialists to determine the tactics of reference.

Diagnosis of acute cholecystitis

Ultrasound can detect signs of acute cholecystitis: thickening of the gallbladder walls more than 3-4 mm, "doubled" contour of the wall and an increase in the size of the organ, perivesical fluid. With a dynamic study, you can judge the form of the inflammation of the gallbladder.

Symptoms of acute cholecystitis

Acute cholecystitis begins acutely, suddenly, often at night, with severe pain in the right hypochondrium, epigastric region, less frequently in other areas of the abdomen (in preschool children). The child is extremely restless, rushes in bed, trying to find a position that alleviates the pain. There is nausea, vomiting with an admixture of bile, 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 fever). The pathogenetic role of enzymes and proenzymes of the pancreas, entering the bile ducts and the gallbladder and provoking acute fermentative cholecystitis, is investigated.

Acute cholecystitis in children

How are bile duct dyskinesias treated?

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

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