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Biliary tract disease and acute non-A-E hepatitis in Hong Kong: prospective study
1Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong.
Objective:
To investigate the role of biliary tract disease in patients with acute non-A-E hepatitis.
Design:
Prospective study.
Setting:
Infectious diseases unit, government hospital, Hong Kong.
Patients:
Sixty-one consecutive patients, admitted with the diagnosis of acute hepatitis and negative hepatitis serology for hepatitis A, B, C, D, and E virus.
Main Outcome Measures:
Abdominal ultrasound and endoscopic retrograde cholangiopancreatography findings; clinical outcome.
Results:
Ultrasonographic abnormalities indicating biliary tract disease were found in 30% (18/61) of patients. Endoscopic retrograde cholangiopancreatography performed in 78% (14/18) of patients with abnormal ultrasound finding(s) confirmed the presence of biliary tract disease. Age, sex, serum alanine aminotransferase level, and serum albumin level were independent predictors of biliary tract disease in the patients studied.
Conclusion:
Biliary tract diseases were found in 20% of patients with acute non-A-E hepatitis. Serum amylase and abdominal ultrasonography should be performed for all patients presenting with acute non-A-E hepatitis. Endoscopic retrograde cholangiopancreatography is indicated for those with apparent gallstones or abnormal biliary tract findings.