Sonographic Evidence of Ascites, Pleura-Pericardial Effusion and Gallbladder Wall Edema for Dengue Fever

2011 ◽  
Vol 26 (5) ◽  
pp. 335-341 ◽  
Author(s):  
M. Motla ◽  
S. Manaktala ◽  
V. Gupta ◽  
M. Aggarwal ◽  
S.K. Bhoi ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Gall Bladder ◽  
Renal Dysfunction ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Gallbladder Wall ◽  
World Population ◽  
Gall Bladder Wall ◽  
The Mean

AbstractIntroduction: Radiographic findings of dengue fever have not yet been clearly elucidated in relation to clinical and serological findings, despite the fact that two-fifths of the world population lives in areas where the virus is endemic. The current study is a retrospective analyzis of ultrasonographic (USG) features of patients presenting with probable dengue fever during the outbreak of DF of 2006 in North India.Methods: Case records of a 169 patients with probable dengue fiver were included. Ten individual sonographic parameters were reviewed vis-à-vis ascites, hepatomegaly, splenomegaly, gall bladder wall edema (GBWE), pleural effusion (right or left or both), pericardial effusion, pericholecystic collection, perinephric collection. Subjects who had GB wall thickness >3 mm as measured on ultrasound were identified as positive for GBWE. The cases were analyzed in view of their serological profile.Results: The mean age of the subjects was 27.9 +/− 13.4 years. The mean value of the platelet count was 57.4 +/− 22.3 x 103/cmm. The most common ultrasonographic feature was ascites (126, 74.6%) followed by gall bladder wall edema (122, 72%), hepatomegaly (78, 46.2%), splenomegaly (66, 39.1%) and pericholecystic collection (63, 37.3%); 48 (28.4%) subjects demonstrated evidence of pleural effusion on the right side, while 19 (11.2%) had bilateral effusion. None of the subjects had an isolated left pleural effusion. Twenty-seven (16%) subjects reported bleeding manifestations in the form of petechiae and five (3%) developed renal dysfunction. Presence of pleural and pericardial effusions was found to be specific while ascites and GBWE were identified as highly sensitive markers for seropositive Primary DF.Conclusions: Ultrasonographic evidence of ascites, pleuro-pericardial effusion, and gallbladder wall edema are rapidly aquired, non-invasive markers of dengue and can be helpful before serological investigations become available. These findings may indicate severity and may herald the onset of bleeding (petechiae) or predict the development of acute renal dysfunction.

scholarly journals A Study on Role of Ultrasonography in the Diagnosis of Dengue Fever

2020 ◽  
Vol 8 (1) ◽  
pp. 139-143
Author(s):  
Y. Thathayya Naidu ◽  
R. Kiranmai
Keyword(s):  
Pleural Effusion ◽  
Gall Bladder ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Wall Thickening ◽  
Imaging Method ◽  
Febrile Patient ◽  
Epidemic Area ◽  
Ultrasound Findings ◽  
Gall Bladder Wall

Background: Dengue Fever is an acute mosquito transmitted viral infection caused by one of the 4 serotypes of the genus flavivirus which has become a major international public health problem. The diagnosis of DF is often delayed owing to time taken for availability of serology test results. Moreover, this test is expensive and not widely available. Ultrasonography (USG) is a cheap, rapid and widely available non-invasive imaging method. In recent years several studies concluded that Ultrasonography of the chest and abdomen can be an important adjunct to clinical profile in diagnosis of DF and diagnosis can be made early in the course of the disease compared with other modes of diagnosis. The aim of  the study is to demonstrate the ultrasound findings of dengue fever and also evaluate the specificity of gall bladder findings in dengue fever. Subjects and Methods: We conducted a prospective study in Govt Medical College& Hospital, Srikakulam and Konaseema Institute of Medical Sciences, Amalapuram, A.P. Study included 50 patients referred to the department of Radio-Diagnosis and Imaging for Ultrasonography with clinical suspicion of dengue fever, during a period of July 2018 to December 2019. USG of the abdomen, pelvis and chest was performed in  all cases and findings were noted. Dengue serology was performed later and all the ultrasound findings were correlated with dengue serology. Results:  In our study of 50 patients all the patients studied were diagnosed with dengue fever based on dengue serology. In our study, 100%  of our patients diagnosed with DF (by dengue serology) showed gall bladder wall thickening, 88% showed splenomegaly, 44% showed ascites. Pleural effusion was present in 30% of which 66.66% of pleural effusion was bilateral and the rest 33.33% was right sided. Isolated left sided pleural effusion was not found in our study. Hepatomegaly was present in 28% of our patients. In our study mortality and complications from dengue fever were not seen. Conclusion: Ultrasound findings in dengue fever are gall bladder wall thickening, splenomegaly, ascites, pleural effusion and hepatomegaly. In an area where DF is an epidemic, when Ultrasonography shows gall bladder wall thickening in a febrile patient with thrombocytopenia DF should be suggested On Ultrasonography, when there is gall bladder wall thickening, splenomegaly, ascites, and pleural effusion in a febrile patient with thrombocytopenia in a DF epidemic area a diagnosis of DF should be considered in a differential diagnosis until proved otherwise.

scholarly journals Patterns of Gall Bladder Wall Thickening in Dengue Fever: A Mirror of the Severity of Disease

2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Warning Signs ◽  
Severe Dengue ◽  
Wall Thickening ◽  
Severity Of Disease ◽  
Gall Bladder Wall ◽  
Track Pattern ◽  
Honeycomb Pattern

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.

scholarly journals Role of gallbladder wall thickness in predicting laparoscopic operability prior to cholecystectomy: a retrospective analysis

2018 ◽  
Vol 5 (5) ◽  
pp. 1885
Author(s):  
Priyank Pathak ◽  
Rihan Zaidi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wall Thickness ◽  
Open Surgery ◽  
Bladder Wall ◽  
Gallbladder Wall ◽  
Bladder Wall Thickness ◽  
Conversion To Open Surgery ◽  
Gall Bladder Wall ◽  
Calculous Cholecystitis

Background: Laparoscopic cholecystectomy is the gold standard procedure for cholecystitis. There are variable rates of conversion of laparoscopic cholecystectomy to open cholecystectomy. Various studies have highlighted gall bladder wall thickness of > 3mm as an independent risk factor for conversion. The purpose of our study is to predict the feasibility of cholecystectomy laparoscopically bases on the pre-operative ultrasound guided measurement of gall bladder wall thickness.Methods: It is a retrospective study conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS) from June 2016 to September 2017. Patient’s pre-operative complete haemogram, liver function tests were also analyzed. Gallbladder wall thickness was estimated by using the maximal obtainable measurement at the fundus. A thin gallbladder wall was less than 3 mm in diameter. A thick gallbladder wall was 3 mm or greater in diameter.Results: A total of 192 patients were included in this study. Most of the patients were of the age group between 30-40 years, with average age of 37 years and 70% of the patients were females. Out of 192, 176 patients underwent laparoscopic cholecystectomy and 16 patients required conversion to open surgery. Ninety patients (46.8%) had cholecystectomy for acute cholecystitis and one hundred two patients (53.15%) had cholecystectomy for chronic cholecystitis. The gallbladder wall was found to be greater than 3 mm in 23 patients (25.5%) with acute calculous cholecystitis and greater than 3 mm in 25 patients (24.5%) with chronic calculous cholecystitis. Forty-eight patients, out of a total of 192, had a gallbladder wall thickness greater than 3 mm by preoperative sonography and 16 of these patients (33.3%) required conversion to an open cholecystectomy.Conclusions: Gall bladder wall thickness bases on ultrasound is a good predictor for difficult cholecystectomy and conversion to open surgery.

Ultrasound Measurement of the Gallbladder Wall Thickness in the Assessment of the Risk of Conversion from Elective Laparoscopic Cholecystectomy to Open Surgery — Olkusz County Experience

2016 ◽  
Vol 88 (6) ◽  
Author(s):  
Dariusz Kania
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wall Thickness ◽  
Bladder Wall ◽  
Gallbladder Wall ◽  
Categorical Variables ◽  
Ultrasound Measurement ◽  
Intestinal Fistula ◽  
Bladder Wall Thickness ◽  
Gall Bladder Wall

Abstractwas to assess the risk of intraoperative difficulties, conversion and biliary-intestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gall-bladder wall thickness.A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χThe relationship between the gall-bladder wall thickness and the occurrence of intraoperative difficulties in the analysed set is deterministic (AUC = 1), and the wall thickness of ≥ 5 mm allows to predict their occurrence as soon as at the stage of diagnostic evaluation (p < 0.001). In addition, the ultrasound-measured GB wall thickness is a good predictor of conversion (AUC = 0.976; 95% CI 0.444–0.975; p < 0.001) and biliary-intestinal fistula (AUC = 0.935; 95% CI 0.121–0.738; p = 0.001).The results allow prediction of technically difficult laparoscopic cholecystectomies in patients with CCh, and selection of the right surgical team helps to reduce the number of conversions and possible complications. In addition, bearing in mind the above results in everyday practice should facilitate planning and increase effectiveness in the operating room.

scholarly journals A study on correlation of gall bladder wall thickness with severity of Dengue fever

2019 ◽  
Vol 6 (6) ◽  
pp. 2476
Author(s):  
Vijayalakshmi A. ◽  
Sreelekha P. ◽  
Kalashankar D.
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Wall Thickness ◽  
Bladder Wall ◽  
Tertiary Care ◽  
Fatal Outcome ◽  
Warning Signs ◽  
Severe Dengue ◽  
Bladder Wall Thickness ◽  
Gall Bladder Wall

Background: Dengue is an acute viral infection with potentially fatal complications. This study was done to describe the correlation of Gall bladder wall thickness with severity of Dengue fever and to predict the fatal outcome of Dengue fever at the earliest to prevent serious consequences by timely interventions.Methods: This was a hospital based prospective observational study conducted at Niloufer Hospital, a tertiary care pediatric hospital attached to Osmania Medical College, Hyderabad, Telangana, India from October 2017 to November 2018. All children between 1 year to 12 years of age that had clinical features of dengue and who were serologically confirmed were included in this study.Results: Age group most commonly affected was 5-8 years with maximum number of dengue cases without warning signs (55.7%). Majority of severe dengue cases (64.3%) had gall bladder wall thickness >5mm. The correlation between severity of dengue and gall bladder wall thickness was found to be highly significant indicating the higher the severity of dengue more the gall bladder thickness.Conclusions: This study concludes gallbladder wall thickness (GBWT) measured by ultrasonography can be used in children for early prediction of the severity of DHF in children and authors can include gall bladder wall thickness as an admission criteria during epidemics.

scholarly journals Retrospective analysis of ultrasound features of dengue infection

2017 ◽  
Vol 5 (12) ◽  
pp. 5260
Author(s):  
Denesh Narasimhan ◽  
Silpita Katragadda ◽  
M. Sathish
Keyword(s):  
Platelet Count ◽  
Pleural Effusion ◽  
Gall Bladder ◽  
Bladder Wall ◽  
Dengue Infection ◽  
Common Finding ◽  
Wall Thickening ◽  
Ultrasound Evaluation ◽  
Gall Bladder Wall ◽  
Ultrasound Features

Background: Dengue infection is an extremely common infection in tropical countries. It is considered to be prevalent all-round the year. The aim of the study was to analyse the ultrasound features of serologically proven dengue cases. To correlate the platelet count with ultrasound features of dengue.Methods: Study included dengue patients admitted from January 2011 to December 2012. Dengue was diagnosed by IgM antibody test. All patients underwent ultrasound evaluation and platelet count testing.Results: most common finding was ascites in 43 cases (39.8%), splenomegaly in 41 cases (37.9%), right sided pleural effusion in 25 cases (23.4%), gall bladder wall thickening was present in 30 cases (27.7%) and hepatomegaly was present in 20 cases (18.5%). Presence of most of the features of ultrasound evaluation correlated with a platelet count of less than 40000 cells/mm3.Conclusions: The commonest sonographic findings were ascites and splenomegaly followed by pleural effusion and gall bladder wall thickening. Thus, presence of these ultrasound features in a febrile patient may be suggestive of dengue fever and presence of all the sonographic features may suggest a low platelet count.

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