title: Age, Predisposing Diseases, and Ultrasonographic Findings in Determining Clinical Outcome of Acute Acalculous Inflammatory Gallbladder Diseases in Children.
abstract: We evaluated clinical factors such as age, gender, predisposing diseases and ultrasonographic findings that determine clinical outcome of acute acalculous inflammatory gallbladder diseases in children. The patients were divided into the four age groups. From March 2004 through February 2014, clinical data from 131 children diagnosed as acute acalculous inflammatory gallbladder disease by ultrasonography were retrospectively reviewed. Systemic infectious diseases were the most common etiology of acute inflammatory gallbladder disease in children and were identified in 50 patients (38.2%). Kawasaki disease was the most common predisposing disease (28 patients, 21.4%). The incidence was highest in infancy and lowest in adolescence. The age groups were associated with different predisposing diseases; noninfectious systemic disease was the most common etiology in infancy and early childhood, whereas systemic infectious disease was the most common in middle childhood and adolescence (P = 0.001). Gallbladder wall thickening was more commonly found in malignancy (100%) and systemic infection (94.0%) (P = 0.002), whereas gallbladder distension was more frequent in noninfectious systemic diseases (60%) (P = 0.000). Ascites seen on ultrasonography was associated with a worse clinical course compared with no ascites (77.9% vs. 37.7%, P = 0.030), and the duration of hospitalization was longer in patients with ascites (11.6 ± 10.7 vs. 8.0 ± 6.6 days, P = 0.020). In conclusion, consideration of age and predisposing disease in addition to ultrasonographic gallbladder findings in children suspected of acute acalculous inflammatory gallbladder disease might result in better outcomes.
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Dae Yong
authors.identifier: http://orcid.org/0000-0002-4168-7131
authors.initials: DY
authors.lastname: Yi
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun Jae
authors.identifier: http://orcid.org/0000-0003-0595-0972
authors.initials: EJ
authors.lastname: Chang
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ji Young
authors.identifier: http://orcid.org/0000-0003-1466-2112
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun Hye
authors.identifier: http://orcid.org/0000-0002-9270-9783
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. hrlamb@hanmail.net.
authors.forename: Hye Ran
authors.identifier: http://orcid.org/0000-0002-3423-6922
authors.initials: HR
authors.lastname: Yang
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D001201:Ascites / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005704:Gallbladder / Q000503:physiopathology*; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis / Q000473:pathology; D012189:Retrospective Studies; D012737:Sex Factors; D014463:Ultrasonography
keywords: Acute Acalculous Cholecystitis; Age; Child; Clinical Outcome; Gallbladder; Ultrasonography