Involvement of the gallbladder in the course of viral hepatitis A in childhood

2019 ◽  
Vol 49 (4) ◽  
pp. 271-273
Author(s):  
Valeri Velev ◽  
Metodi Popov ◽  
Latchezar Tomov ◽  
Branimir Golemanov
Keyword(s):  
Significant Relationship ◽  
Hepatitis A ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Laboratory Evaluation ◽  
Wall Thickening ◽  
Acute Acalculous Cholecystitis ◽  
Acute Hepatitis A ◽  
Viral Hepatitis A

The course of acute hepatitis A (AHA) in childhood is most often benign. There are relatively few reports of gallbladder involvement during such infection and its consequences. We discuss the cases of 75 children (mean age = 4.5 years) with confirmed AHA. Clinical and laboratory evaluation upon admission were classical for AHA. Only two children had normal bilirubin levels and 38.7% had visible involvement of the gallbladder with wall thickening of >3 mm, while six met criteria for acute acalculous cholecystitis. There appears to be no clear relationship between thickening of the gallbladder wall and transaminase levels, but a significant relationship with total and direct bilirubin levels ( P < 0.05). Ultrasonographic examination should therefore be carried out in each case of AHA and follow-up should be performed with greater caution, if there are changes in the gallbladder wall.

scholarly journals Acute Acalculous Cholecystitis due to Viral Hepatitis A

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Safak Kaya ◽  
Ahmet Emre Eskazan ◽  
Nurettin Ay ◽  
Birol Baysal ◽  
Mehmet Veysi Bahadir ◽  
...  
Keyword(s):  
Viral Hepatitis ◽  
Hepatitis A ◽  
Acute Viral Hepatitis ◽  
Rare Complication ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Surgical Trauma ◽  
High Morbidity ◽  
Viral Hepatitis A ◽  
Acute Viral Hepatitis A

Inflammation of the gallbladder without evidence of calculi is known as acute acalculous cholecystitis (AAC). AAC is frequently associated with gangrene, perforation, and empyema. Due to these associated complications, AAC can be associated with high morbidity and mortality. Medical or surgical treatments can be chosen according to the general condition of the patient, underlying disease and agent. Particularly in acute acalculous cholecystitis cases, early diagnosis and early medical treatment have a positive effect on the patient and protect them from surgical trauma. ACC is a rare complication of acute viral hepatitis A. Herein, we present an adult patient of acalculous cholecystitis due to acute viral hepatitis A. She responded to the conservative management.

scholarly journals Is Routine Ultrasound Examination of the Gallbladder Justified in Critical Care Patients?

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Pavlos Myrianthefs ◽  
Efimia Evodia ◽  
Ioanna Vlachou ◽  
Glykeria Petrocheilou ◽  
Alexandra Gavala ◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Imaging Finding ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Apache Ii Score ◽  
Wall Thickening ◽  
Acute Acalculous Cholecystitis ◽  
Laboratory Findings ◽  
Ultrasound Monitoring ◽  
Gallbladder Wall Thickening

Objective. We evaluated whether routine ultrasound examination may illustrate gallbladder abnormalities, including acute acalculous cholecystitis (AAC) in the intensive care unit (ICU).Patients and Methods. Ultrasound monitoring of the GB was performed by two blinded radiologists in mechanically ventilated patients irrespective of clinical and laboratory findings. We evaluated major (gallbladder wall thickening and edema, sonographic Murphy’s sign, pericholecystic fluid) and minor (gallbladder distention and sludge) ultrasound criteria.Measurements and Results. We included 53 patients (42 males; mean age57.6±2.8years; APACHE II score21.3±0.9; mean ICU stay35.9±4.8days). Twenty-five patients (47.2%) exhibited at least one abnormal imaging finding, while only six out of them had hepatic dysfunction. No correlation existed between liver biochemistry and ultrasound results in the total population. Three male patients (5.7%), on the grounds of unexplained sepsis, were diagnosed with AAC as incited by ultrasound, and surgical intervention was lifesaving. Patients who exhibited ≥2 ultrasound findings (30.2%) were managed successfully under the guidance of evolving ultrasound, clinical, and laboratory findings.Conclusions. Ultrasound gallbladder monitoring guided lifesaving surgical treatment in 3 cases of AAC; however, its routine application is questionable and still entails high levels of clinical suspicion.

scholarly journals Prognostic value of gallbladder wall thickening in patients with acute hepatitis A

2015 ◽  
Vol 34 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Jhii-Hyun Ahn ◽  
Jae-Joon Chung ◽  
Jeong-Sik Yu ◽  
Joo Hee Kim ◽  
Eun-Suk Cho ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Prognostic Value ◽  
Hepatitis A ◽  
Gallbladder Wall ◽  
Wall Thickening ◽  
Acute Hepatitis A ◽  
Gallbladder Wall Thickening

scholarly journals Gallbladder Wall Thickening associated with Dengue Shock Syndrome in a German traveller – no indication for surgical therapy – a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Noemi F. Freise ◽  
Björn Jensen ◽  
Verena Keitel ◽  
Tom Luedde
Keyword(s):  
Dengue Virus ◽  
Surgical Therapy ◽  
Clinical Symptoms ◽  
Dengue Shock Syndrome ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Wall Thickening ◽  
Acute Acalculous Cholecystitis ◽  
Virus Infections ◽  
Gallbladder Wall Thickening

Abstract Background With the increasing number of dengue virus infections imported into Germany, knowledge about the different phases of the disease and possible complications is essential for the treatment of patients. The virus is endemic in the tropics and subtropics and up to 2.5 billion people are at risk of infection. Case presentation Here we present a German traveller with dengue shock syndrome after returning from Thailand. After hospitalization the patient developed acute upper abdominal pain. The ultrasound findings were consistent with an acute acalculous cholecystitis, but were interpreted as dengue associated gallbladder wall thickening (GBWT). Therefore a surgical intervention was not indicated and would have been associated with an higher risk of complications in this situation. Under supportive care spontaneous regression of GBWT could be documented by sonography four days later as well as complete resolution of clinical symptoms. Conclusion GBWT in dengue virus infection mimicking acute cholecystitis is a differential diagnosis one should take into consideration in travellers returning from endemic areas and should be managed conservatively because of an high risk of bleeding and increased mortality under surgical therapy.

scholarly journals No evidence of transmission from an acute case of hepatitis A in a foodhandler: follow-up of almost 1,000 potentially exposed individuals, London, United Kingdom, April 2012

2014 ◽  
Vol 19 (30) ◽  
Author(s):  
V Hall ◽  
A Abrahams ◽  
D Turbitt ◽  
S Cathcart ◽  
H Maguire ◽  
...  
Keyword(s):  
Hepatitis A ◽  
Hepatitis A Virus ◽  
International Health ◽  
The European Union ◽  
Acute Case ◽  
Public Health Agencies ◽  
Health Agencies ◽  
Acute Hepatitis A ◽  
Health Regulations

Identification of acute hepatitis A virus (HAV) infection in a foodhandler in a London hotel led to a large incident response. We identified three potentially exposed groups: hotel staff who had regularly consumed food prepared by the case and shared toilet facilities with the case, patients who shared the same hospital ward as the case and hotel guests who consumed food prepared by the case. We arranged post-exposure HAV vaccination for all 83 potentially exposed hotel staff and all 17 patients. We emailed 887 guests advising them to seek medical care if symptomatic, but did not advise vaccination as it was too late to be effective for most guests. Through the International Health Regulations national focal points and the European Union Early warning and response system (EWRS), we communicated the details of the incident to public health agencies and potential risk of HAV transmission to international guests. Potentially exposed hotel staff and guests were asked to complete an online or telephone-administered questionnaire 50 days following possible exposure, to identify any secondary cases. Survey response was low, with 155 responses from guests and 33 from hotel staff. We identified no secondary cases of HAV infection through follow-up.

scholarly journals Acute acalculous cholecystitis on a COVID-19 patient: a case report

2020 ◽  
Author(s):  
Edoardo Mattone ◽  
Maria Sofia ◽  
Elena Schembari ◽  
Valentina Palumbo ◽  
Rosario Bonaccorso ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gastrointestinal Symptoms ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Acute Acalculous Cholecystitis ◽  
Surgical Risk ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Vascular Insufficiency ◽  
High Surgical Risk

Abstract Background coronavirus disease-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Conclusions acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

scholarly journals Two Siblings with Fulminant Viral Hepatitis A: Case Report

2005 ◽  
Vol 48 (3-4) ◽  
pp. 173-175 ◽  
Author(s):  
Mehmet Yalniz ◽  
Hüseyin Ataseven ◽  
Selman Çelebı ◽  
Orhan Kürşat Poyrazoğlu ◽  
Nusret Sirma ◽  
...  
Keyword(s):  
Case Report ◽  
Virus Infection ◽  
Fulminant Hepatitis ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Rare Complication ◽  
Mild Disease ◽  
Epidemic Period ◽  
Acute Hepatitis A ◽  
Viral Hepatitis A

Fulminant hepatitis is a rare complication of acute hepatitis A infection. Nevertheless, the seroepidemiology of the infection is rapidly changing with the developing world, rendering more adults susceptible to the infection, in particular with more severe course. We report here fulminant hepatitis A infection with a mortal course during an epidemic period in two siblings. Although it causes a self-limited mild disease, hepatitis A virus may have a severe course including fulminant hepatitis and may lead to mortality, especially in older ages. Hence, the risk of hepatitis A virus infection and its complications should be reduced with measures of immunization and sanitation.

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