Pediatric Cholecystitis Differential Diagnoses

Updated: Oct 20, 2017
  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Carmen Cuffari, MD  more...
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Diagnostic Considerations

The differential diagnosis of cholecystitis is based on the presenting symptom of right upper quadrant abdominal pain. In the pediatric population, consider the following conditions in addition those listed in Differentials:

  • Biliary colic
  • Cholangitis
  • Rupture of the gallbladder
  • Peptic ulcer disease
  • Renal colic
  • Gastritis
  • Pleurisy
  • Fitz-Hugh and Curtis syndrome (gonococcal perihepatitis)
  • Hepatic abscess
  • Abdominal tumor
  • Pyelonephritis

Infants with cholecystitis may present with irritability, jaundice, and acholic stools. Because of young age and differing presentation, consider congenital bile duct anomalies, such as biliary atresia and paucity of intrahepatic bile ducts.

Acalculous cholecystitis usually occurs in children with preexisting systemic illness and, therefore, may be masked by other conditions and analgesics. Be sensitive to the possibility of cholecystitis if systemic infection and multiple risk factors are present.

Differential Diagnoses