Cholecystitis in a child: description, possible causes and characteristics of treatment

Inexperienced parents, any pain in the abdomen of their baby is associated with the quantity and quality of food. They are sure that it is enough to give a dose of sorbents or enzymes, and everything will pass. But it is not always the case. The cause of pain can be the inflammatory process of the biliary tract system, that is, the cholecystitis in the child. Strangely enough, but the inflammation of the gallbladder and ducts happens quite often. The disease can be acute or chronic. In most cases, the chronic form is diagnosed at the time of exacerbation or relapse.

Provocators of the disease

Cholecystitis in a child can provoke an E. coli, a protein or cocci, caught in a favorable environment. These conditions include infection with protozoa, that is, lambliasis, helminthic invasion, pathology of the bile excretory system. The main causes of cholecystitis are divided into 2 groups:

• Parasitic;
• Microbial.

Chronic cholecystitis in children is often associated with the presence of other foci of inflammation, it can be, for example, angina or tonsillitis. In many cases, the disease provokes previous diseases, such as gastritis, colibacillosis, duodenitis, appendicitis, influenza, scarlet fever, dysentery.

Inflammation of the gallbladder or bile ducts can be triggered by a systematic violation of diet, the absorption of a large amount of fatty foods and carbohydrate-containing foods, a clear lack of vegetables and fruits in the diet.

Mechanism of manifestation of the disease. Chronic cholecystitis

Cholecystitis in a child in a chronic form can be purulent or catarrhal. The catarrhal form is associated with inflammation of the mucous membranes. In this case, the wall of the gallbladder thickens and becomes thicker, and the lining body from the inside becomes mucosal atrophy.

Purulent cholecystitis is characterized by the involvement of all tissues in the wall. In the body abscesses are formed, which become a source of regular exacerbations of chronic cholecystitis. When the disease recurs, the gall bladder becomes edematous. A characteristic feature is a thickening of the mucosa, the appearance of polyps and ulcers.

When healing ulcers are replaced with a connective tissue, scars appear. Occasionally, spikes are formed with closely located organs. This process is called perocholecystitis.

An ulcer can lead to the formation of a fistula and the development of biliary peritonitis. If the cholecystitis in the child leads to clogging of the bile duct, gall bladder edema may develop. Chronic cholecystitis can affect the liver, diaphragm and abdominal wall. The aggravation of the process provokes an abscess in these organs. In difficult cases, external bile fistulas can appear.

Acute cholecystitis

Acute cholecystitis in children may require surgical intervention. However, this happens infrequently. Usually, the development of the disease is associated with the infection that has spread through the bloodstream or the current of the lymph. At an early age, the most common factor in the development of an acute process is intestinal infections and bile stagnation due to constipation or flatulence.

As a result of acute cholecystitis a high concentration of lysolecithin is created. Bile salts damage the mucous membrane of the bladder, disrupting the permeability of cell membranes. Since the immune defense in children is not completely formed, the edema and secondary bile hypertension develop.

Manifestation of symptoms

How is cholecystitis manifested in children? Symptoms may be vivid or mild. Usually it is a complaint of bitterness in the mouth, a significant decrease in appetite, attacks of nausea and vomiting, constipation or diarrhea. However, the main sign of cholecystitis is pain in the right upper quadrant. Painful sensations can be paroxysmal and last from several minutes to several hours or permanent.

One of the main symptoms of the disease is soreness and enlargement of the liver. Sometimes palpation feels the tension of the abdominal wall above the gall bladder. Many children have a low febrile temperature for a long time. If you combine the symptoms into one list, it will look like this:

1. Pains of paroxysmal or permanent nature, localized on the right under the ribs. Increase a few hours after eating, accompanied by a sense of heaviness and overflow.
2. Dyspepsia, that is, an upset digestive system. Bitter or metallic aftertaste, frequent eructations, nausea, increased gas formation in the intestines, unstable stools.
3. Low temperature for a long time, general irritability, insomnia.

Parents should understand that, despite the obvious manifestations of the disease, the establishment of an independent diagnosis is unacceptable. Only a doctor can confirm cholecystitis in children. Symptoms and treatment of this disease depend on the severity of the patient's condition. The specialist, taking into account the clinical picture and on the basis of the results of the analyzes, selects the appropriate type of therapy.

Conducting diagnostics

First of all, the doctor talks with the patient or his parents and collects an anamnesis. Further clinical and laboratory studies are carried out. This is an obligatory detailed blood test and biochemistry.

Echography is used to confirm the diagnosis. This examination allows you to determine the change in the size and thickness of the gallbladder walls. In addition, there is a violation of organ contractions. In addition, it is desirable to conduct duodenal sounding and ultrasound.

Additionally, the bile is examined. The analysis shows a decrease in specific gravity and an increase in acidity.

Additional information about the form of the disease

It often happens that the professional speech of a doctor is not always clear to an unprepared person. For example, if the doctor tells the patient's parents that he has a non-calculous form of cholecystitis, this means that the disease is not associated with the formation of gallstones. Simpler children's form is called beskamennoy.

Treatment

Treatment of cholecystitis in children is carried out according to a certain scheme:

1. Compliance with bed rest at home.
2. Reception of antibiotics according to the doctor's prescription.
3. Reception of choleretic preparations.
4. If necessary - taking antiparasitic drugs.
5. A complex of vitamins with a high content of group B and C.
6. Taking antispasmodics to reduce pain.
7. The appointment of drugs that improve liver function.

Chronic forms of cholecystitis are usually treated at home, but with an aggravation of the process it is desirable to hospitalize the baby. The first day after an exacerbation the child is prescribed a complete starvation, and later the parents will have to monitor compliance with a strict diet. Children with cholecystitis are put on dispensary records.

Compliance with diet

To cure a baby without observing certain rules of nutrition is impossible. Diet for cholecystitis of children means boiled or steam food in a crushed form. The doctor appoints a dietary table number 5 or 5a.

In the diet should not be spicy and sharp additives, smoked products, fatty foods and fried foods. Portions should be small, since you can not overeat the child.

In the diet of a small patient, sunflower oil, cottage cheese, fish and meat in steam or boiled form, fruits, vegetables or light salads are necessarily introduced.

Preventive measures

All parents want to see their kids healthy. In order for a child not to have cholecystitis, it is important to monitor his nutrition, not to overeat and eat up at night. Do not give the child a popular snack in the form of snacks, crackers and chips. It is advisable to adhere to regular fractional and frequent meals.

Children must necessarily lead an active lifestyle. This will help to avoid not only cholecystitis, but also many other problems. Morning exercise, sports groups, tourism, outdoor games - a normal pastime for a healthy child.

Try not to admit or at least in time to identify other gastrointestinal infections and diseases, because in the body everything is interconnected.

Conduct preventive treatment of helminthiases if you assume that the child could pick up parasites in the kindergarten, at school, at home or in the common sandbox in the yard.

As prescribed by the doctor, take cholagogue and mineral water. And most importantly - keep an eye on your child's condition, since it's easy to miss the onset of the disease or its aggravation, but it's quite hard to treat it. Subsequently, even a surgical intervention can be recommended to the baby.