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Symptoms of chronic cholecystitis
Last reviewed: 23.04.2024
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Symptoms of chronic cholecystitis in children begin gradually, proceed for a long time with periods of deterioration (exacerbations) and improvement (remissions). There are headaches, fatigue, lethargy, sleep and appetite disorders. Possible subfebrile condition, pale skin, dark circles under the eyes, functional changes in the cardiovascular system (tachy, bradycardia, arrhythmia, blood pressure jumps).
The cardinal sign of chronic cholecystitis is abdominal pain. The pain is usually dull, indeterminate, occurs 30-60 minutes after eating, especially greasy, fried, high protein. They note nausea, heartburn, belching food and air, bitterness in the mouth, vomiting (more often in preschool children). Often the pain arises after physical exertion (running, lifting weights), with a shaking of the body (sports, traveling on transport), due to stress, against the background or soon after intercurrent illnesses, sometimes for no apparent reason. With exacerbation of chronic cholecystitis, pain is severe, paroxysmal, resembling the syndrome of an acute abdomen. Note the irradiation of pain in the right shoulder and scapula, the right lumbar region. The duration of the attack is from several minutes to 0.5-1 hours, rarely longer. Children repeatedly go to the hospital with suspicion of acute appendicitis.
After the pain subsides, children of predominantly school age complain of the severity or discomfort in the right upper quadrant (right hypochondrium syndrome) and the epigastric region.
The second cardinal symptom of chronic cholecystitis is moderate hepatomegaly. The liver protrudes from under the edge of the rib arc on the right middle clavicle line, usually 2 cm, rarely 3-4 cm, moderately painful on palpation, soft elastic consistency, with a rounded edge.
Jaundice staining of the skin, icteric sclera is rarely observed (5-7%), in children of school age in this case it is necessary to conduct differential diagnosis with Gilbert syndrome (benign hyperbilirubinemia).
With prolonged course of chronic cholecystitis and frequent exacerbations, pericholecystitis, periduodenitis may develop. Cholangitis, papillitis and other complications. There are conditions for the formation of concrements both in the gall bladder and in the bile ducts. In the case of a siphon, the bubble ceases to function (the "disconnected" gallbladder). If there are fusions between the gall bladder and the right bend of the large intestine, the development of the Verbraic syndrome is possible. Children have recurrent pain in the right upper quadrant of the abdomen or epigastric region, accompanied by nausea and flatulence. Symptoms of chronic cholecystitis are most pronounced in the day when children are in an upright position, move a lot, change the position of the body.
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