scholarly journals Letter to Editor Commenting on “Patterns of Gall Bladder Wall Thickening in Dengue Fever” – Reply

2017 ◽  
Vol 03 (04) ◽  
pp. E166-E166
2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora

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.


2020 ◽  
Vol 8 (1) ◽  
pp. 139-143
Author(s):  
Y. Thathayya Naidu ◽  
R. Kiranmai

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.


HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S711-S712
Author(s):  
K. Vishnu ◽  
V. Gupta ◽  
T.D. Yadav ◽  
B.R. Mittal ◽  
N. Kalra ◽  
...  

2011 ◽  
Vol 26 (5) ◽  
pp. 335-341 ◽  
Author(s):  
M. Motla ◽  
S. Manaktala ◽  
V. Gupta ◽  
M. Aggarwal ◽  
S.K. Bhoi ◽  
...  

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.


1997 ◽  
Vol 12 (6) ◽  
pp. 445-449 ◽  
Author(s):  
TEH-FANG WANG ◽  
SHINN-JANG HWANG ◽  
FA-YAUH LEE ◽  
YANG-TE TSAI ◽  
HAN-CHIEH LIN ◽  
...  

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Birgit Tsaknakis ◽  
Rawan Masri ◽  
Ahmad Amanzada ◽  
Golo Petzold ◽  
Volker Ellenrieder ◽  
...  

2018 ◽  
Vol 28 (2) ◽  
pp. 15-21
Author(s):  
Sandipan Ghose ◽  
Md Azizul Hoque ◽  
MK Rahman ◽  
MMR Khan ◽  
Mohd Harun Or Rashid ◽  
...  

This study was designed to make a relation between gall bladder wall thickening (GBWT) measured by ultrasonography and esophageal varices (EV) measured byupper gastrointestinal endoscopy in chronic liver disease patients. Itwas cross- sectional descriptive study. 50 cases ofChronic Liver Disease were recruited. GBWT was measured by ultrasonography and upper gastrointestinal endoscopy was done for assessment of the presence and grade of EV in all cases. Among 50 cases, 34 (68%) were male and 16(32%) were female. Mean age (±SD) of the study population was 46.7 (±13.28) years of age. Esophageal varices were found in 42(84%) cases and 8(16%) cases had no varix. Among 42 cases of esophageal varices 9 cases had grade-I, 17 cases had grade-II and 16 cases had Grade-III esophageal varices. Gall bladder wall thickness up to 3mm was considered as normal. In this study GBWT value between (1-3) mm8 cases had no EV GBWT value between (3.1-5.9) mm ,10 cases had EV(9 cases had grade 1 and 1 case had grade 11 EV); GBWT value between (6-8.9) mm, 16 cases had grade 11 EV and GBWT value between (9-12) mm 16 cases had grade 111 EV. A significant statistical correlation was found between the level of GBWT and EV (P<0.001) and also between mean GBWT and EV (P<0.001). This study shows that the presence of EV is directly related to the level of GBWT and there is also association with the grade of EV and level of GBWT. This finding will permit the use of GBWT as a preliminary indirect parameter that will predict the presence EV. It can help clinicians in determining the urgency of care, especially where endoscopy facilities are not available.TAJ 2015; 28(2): 15-21


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