CHOLECYSTITIS OR CHOLANGITIS, ACUTE
DESCRIPTIONThese acute conditions refer to infection or inflammation of the gallbladder (cholecystitis) or the ducts (cholangitis) that drain bile from the gallbladder to the small intestine. These conditions may be confused with hepatitis, pancreatitis, or duodenal ulcer. The gallbladder (located under the liver) and bile ducts in the liver leading to the gallbladder are involved. The conditions are most common in adults but may rarely occur in children or adolescents. Appropriate health care includes: doctor's treatment; surgery to remove an infected gallbladder and gallstones (surgery is rarely an emergency); hospitalization (usually).
SIGNS & SYMPTOMSCramping pain in the upper right of the abdomen. Pain may also occur in the chest (imitating a heart attack), in the upper back or the right shoulder. These symptoms frequently follow a meal rich in fats.
Tenderness in the child's upper abdomen.
Nausea and vomiting.
Slight fever. A high fever and chills indicate a bacterial infection.
Pale stools (sometimes).
Skin itching (sometimes).
Inflammation or bacterial infection, which are usually caused by gallstone formation and blockage of bile ducts.
Diet that is high in fat; gallstones, whether or not they have caused symptoms; chronic or acute pancreatitis; coronary-artery disease; family history of gallbladder disease.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should avoid any food that causes indigestion.
Your child should have surgery to remove gallstones, even if they cause no symptoms.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies.
X-rays of the child's gallbladder.
Ultrasonography (See Glossary) of the gallbladder and bile ducts.
Radioisotope studies (See Glossary) of liver and pancreas.
Gallbladder rupture and peritonitis.
Misdiagnosis as a heart attack.
Symptoms of some mild attacks subside spontaneously in 1 to 4 days, if no complications develop. Most episodes require hospitalization and treatment. Recurrences are common. Your child's attacks will cease with surgery to remove the gallbladder.
HOME CAREAfter an acute attack of cholecystitis, consider elective surgery for your child to prevent a future emergency.
MEDICATIONDon't medicate your child with non-prescription pain relievers during an attack. These may mask symptoms of a bacterial infection -- allowing it to worsen -- and delay treatment.
Your doctor may prescribe analgesics, including narcotics, to relieve your child's pain.
See Medications section for information regarding medicines your doctor may prescribe.
Your child should rest in bed until symptoms disappear or recovery from surgery is complete. While in bed, moving the legs often reduces the likelihood of deep-vein blood clotting. Your child may read or watch TV.
DIET & FLUIDS
Because of nausea and vomiting, intravenous fluids are usually necessary during attacks. Clear liquids or a non-fat diet are appropriate as soon as your child can tolerate solid foods.
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of cholecystitis or cholangitis. If symptoms are accompanied by shortness of breath, sweating, and nausea, call immediately! This is an emergency!
The following occurs during an attack: