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Cholecystitis is defined as inflammation of the gallbladder.
- Acute calculous cholecystitis:
- Owing to bile stasis secondary to prolonged obstruction by a gallstone (see “Cholelithiasis”) in the gallbladder neck, cystic duct, or common bile duct
- Leads to increased intraluminal pressure and mucosal damage
- Release of inflammatory mediators results in distention, edema, and increased vascularity.
- Coliforms and anaerobes lead to infection—primary causal role is controversial.
- Acalculous cholecystitis:
- 10% of cases
- Underlying critical illness leads to biliary stasis and mucosal ischemia.
- Subsequent mucosal inflammation and infection
- Acute calculous cholecystitis extremely rare in childhood (see “Cholelithiasis”)
- Acalculous cholecystitis more common than calculous form in children:
- Associated with systemic bacterial infections, scarlet fever, Kawasaki disease, and parasitic infections