Abstract Ref Number = APCP874
CHOLELITHIASIS AND CHRONIC CHOLECYSTITIS IN A TEN-YEAR-OLD BOY
Carissa Lidia,IGN Sanjaya Putra,Putu Gede Karyana,Ni Nyoman Metriani Nesa,I Made Darmajaya,Kadek Deddy Ariyanta
Department of Child Health Udayana University Medical School Sanglah Hospital Department of Pediatric Surgery Udayana University Medical School Sanglah Hospital
Background : Cholelithiasis in children is uncommon and difficult to diagnose because the patient is often asymptomatic and the clinical feature doesn’t clearly depict a cholelithiasis or cholecystitis. Our objective was to describe a rare case of cholelithiasis with chronic cholecystitis in a ten-year-old boy.
Case Presentation Summary : A ten-year-old boy presented with umbilical pain, nausea, and emesis. Physical examination showed there are no tenderness in all abdominal quadrants with negative Murphy sign. Laboratory results revealed elevated white blood count 20,42x103/?L, elevated erythrocyte sedimentation rate 47,2 mm/hour, with normal liver function tests, urine and stool analysis. He underwent transabdominal ultrasound twice, the latest showed signs of cholelithiasis, free fluid around pelvic region due to suspected visceral organ perforation. Laparoscopic cholecystectomy was performed without complication. The result of pathology anatomy examination was chronic cholecystitis. The patient was discharged 3 days after surgery in good condition. The long-term prognosis of the patient was good.
Learning Points/Discussion : In spite of the fact that the patient is male with good nutritional status (not obese), the patient was in the mean age that were identified as key contributors to this disease. Ultrasonography examination is a screening modality that is still a good diagnostic tool with 95% accuracy even though it is highly operator dependent. Laparoscopic cholecystectomy is a gold standard for management even in children with decrease pain and shorter length of stay in hospital.
Keywords: cholelithiasis chronic cholecystitis children