Published online Nov 21, 2018. doi: 10.3748/wjg.v24.i43.4870
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
Processing time: 70 Days and 23.2 Hours
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.
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.