title: Outcome of acalculous cholecystitis from typhoid in Nigerian children.
abstract: BACKGROUND
  Gallbladder perforation and gangrene ordinarily follow obstructive (calculous) cholecystitis with a higher frequency among immunocompromised patients or patients with intense inflammation of the gallbladder. The occurrence of typhoid intestinal perforation is common in the tropics, but GBP and gangrene have been reported sparingly. We report management challenges of 6 children with complications of acalculous cholecystitis from typhoid seen at our center.
  
  
  METHODS
  The patients were retrospectively sorted from the pediatric surgery unit and theater records of January 2000 to December 2006. Information studied included the patients' biodata, presenting features, operative findings, and outcome of management.
  
  
  RESULTS
  There were 6 patients, including 5 boys and a girl, ages ranging 3 to 15 years. The general presentation was that of septicemia. Three had multiple gallbladder perforations, and 3 others had gallbladder gangrene with inflamed Payer's patches on the terminal ileum. All patients underwent open cholecystectomy. There was a case each of postoperative fecal fistula and biliary fistula. All patients survived.
  
  
  CONCLUSIONS
  Acalculous typhoid gallbladder perforation, though rare, presents with management challenges.
authors.affiliation: Pediatric Surgery Unit, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria. bolarjide@yahoo.com
authors.forename: Olajide Lukman
authors.initials: OL
authors.lastname: Abdur-Rahman
authors.forename: Olaniyi James
authors.initials: OJ
authors.lastname: Adeniran
authors.forename: Adegoke Abdul-Rasheed
authors.initials: AA
authors.lastname: Nasir
mesh_terms: D042101:Acalculous Cholecystitis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000150:complications* / Q000453:epidemiology