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This disease occurs at children seldom.
Etiology. Not calculous cholecystitis arises against acute system diseases, including a streptococcal septicaemia (sometimes in combination with a glomerulonephritis), a typhoid, erizipeloid, salmonelloses, a lambliasis, an ascaridosis, leptospirosis and mephitic diphtheroid gangrenes. Communication of cholecystitis with heavy dehydration and insufficiency of food is possible. The case of an inflammation of a gall bladder at the newborn as a result of an amnionitis is described; cholecystitis was observed also at an illness of Kawasaki.
The cholelithiasis (stones of a gall bladder) — the frequent reason of cholecystitis at children is more senior than 15 years. It occurs at boys seldom. Stones consist generally of cholesterol salts, have small diameter. They are seldom localized in the general bilious channel, however, if the channel is kistozno expanded, their forming is very probable there. Despite relative frequency at children of a hemolitic illness, pigmental stones are found only in 10% operated concerning calculous cholecystitis.
The important role in development of cholecystitis in children of chest and early age is played by anomalies of a vesical channel. Full or partial closing of a gleam of the general bilious channel, and also his cyst concern to them (with a secondary cholangitis).
Clinical manifestations. Symptoms of an inflammation of bilious ways at adults and children are identical, however at the last dyspepsia, a meteorism and intolerance of food are seldom noted in the anamnesis. Temperature increase, morbidity in right hypochondrium, the consolidation palpatorno defined are characteristic. Pain is usually localized in right hypochondrium or in epigastriums, sometimes irradiates to the right infrascapular area. At a cholangitis of the patient can test a strong fever. At children jaundice arises more often than at adults.
Diagnosis. Diagnosing cholecystitis (in the absence of jaundice), the preference should be given to the cholecystography; if the nonfunctioning gall bladder is found, then research needs to be repeated. When function of a bubble is not defined again, the intravenous holangiografiya with the purpose to study a condition of a vesical channel is shown. At jaundice apply radio isotope scanning with 99tts-pirrodoksilidin-glyutamatom.
Treatment. The conventional method of treatment — a cholecystectomia. On the operating table carry out a holangiografiya to define whether the drainage of the general bilious channel is necessary. At acute not calculous cholecystitis (a bubble edema) impose holetsistosty and keep a bubble, however most of surgeons-pediatricians prefer a cholecystectomia.