Colecistitis y Colelitiasis en los niños

Abstract

SUMMARYTwo hundred and fifty one clinical records ofpatients with the diagnosis of acute Cholecys-titis and Cholelithiasis, were received at theRoberto del Rio Children's Hospital betweenthe years 1962-1975.Of the 251 patients admited for surgicaltreatment, only 10 of them didn't undergoneoperator, for abcense of clinical symtons attri-butable to Cholecystitis. All the patients we-re under 15 years old, and mos of them inthe age group 12-15 years (76%) 70.9% we-re girls.The typical picture of Acute Cholecystitiswas present in 126 patients, consisting in:severe and acute colic pain, located in theright hypocondrial area. This pain within thehours became permanent. Other importantfeature were: vomiting (84.6%) and fever(58.4%).The physical examination showed an acu-te pain the right hypocondrial area, with thefinding of an hydropic gallbladder in 49.2%of the cases, and inflamatory mass 16.9%The diagnosis of Cronic Cholecystitis wasmade in 105 patients. 14.1% of the patientshad previous biliary colic pain, without feveror malaise.The main clinical symptons were: acutecolic pain in the right hypocondrial area, vo-miting (46%) and hydrops of the gallbladder(23.3%). In this patients and X Rays studywas possible.In patients under 6 years old, Acute Cho-lecystitis was clinically different: They neverhad previous biliary colic pain, or dyspeticdisorders. They came to the Hospital at thefirst colic pain, v/ith fever vomiting and jaun-dice. They were severely ill.The surgical treatment was the same themthe others cases. Only 6 patients had an os-tomy of the gallbladder the opering of thecholecodus was made in 19 cases. Who hadjaundice or palpation of small stones in theduct, during the surgical procedure.X Rays studies of the ducts during theoperation was perfomed in 7% of the cases.The findings of stone by pathologist waspresent in 86.1% of the cases.The post operative course was uneventfuland short, with a very law mortability rate(0.86).