Acute Acalculous Cholecystitis Associated with Hepatitis A Viral Infection: A Case Report

B. Ariobimo, Nurun Nujum, Daniel Ponco Harto Saputro
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Abstract

Most hepatitis A infections are acute, self-limiting, and asymptomatic. In rare instances, extra hepatic complication, such as acute cholecystitis, may emerge. Acute cholecystitis is inflammation of the gallbladder wall and is classified into calculus and acalculus. About 90–95% of cases are brought on by bile duct stones. Acute acalculous cholecystitis can be brought on by structural and functional abnormalities in the gallbladder brought on by viral hepatitis infection. Here we present a 20 years old female patient with acute acalculous cholecystitis associated with hepatitis A infection. Gallbladder distention, thickening of the gallbladder wall, absence of acoustic shadow or biliary sludge, perivesical liquid buildup, and absence of dilatation of the intra- and extrahepatic bile ducts are among the ultrasonographic criteria for diagnosing acute acalculous cholecystitis. The viral hepatitis serology revealed acute hepatitis A infection with positive anti-HAV IgM. Hepatitis A testing should be considered in patients suspected with acalculous cholecystitis of undefined etiology in markedly deranged liver function test adult patients.
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急性无结石性胆囊炎合并甲型肝炎病毒感染1例报告
大多数甲型肝炎感染是急性的、自限性的和无症状的。在极少数情况下,可能出现肝外并发症,如急性胆囊炎。急性胆囊炎是胆囊壁的炎症,分为结石和无结石。约90-95%的病例是由胆管结石引起的。急性无结石性胆囊炎可由病毒性肝炎感染引起的胆囊结构和功能异常引起。我们在此报告一位二十岁的女性病患,患有急性无结石性胆囊炎并甲型肝炎感染。胆囊膨胀、胆囊壁增厚、无声影或胆道淤积、膀胱周围积液、肝内、肝外胆管无扩张是诊断急性无结石性胆囊炎的超声检查标准。病毒性肝炎血清学显示急性甲型肝炎感染,抗hav IgM阳性。在怀疑患有不明原因的结石性胆囊炎和肝功能明显紊乱的成人患者中,应考虑进行甲肝检测。
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