Acalculous gallbladder distension in a young child due to HAV infection: Diagnostic dilemma

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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

D R Suresh1, R Srikrishna, S K Nanda

  • 1Department of Biochemistry, Sri Siddhartha Medical College, Tumkur-07, India ; 3/1, Seethappa layout, 5th Block, Doddabommasandra, Vidyaranyapura. P.O, Bangalore, Karnataka 560097 India.

Indian Journal of Clinical Biochemistry : IJCB
|October 30, 2012
PubMed

Insights

Acute acalculous cholecystitis in children is rare and dangerous. This case highlights Hepatitis A virus as a cause in a pediatric patient, successfully managed conservatively.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Acute acalculous cholecystitis (GBA-AC) is uncommon in children.
  • It carries a high risk of complications like gallbladder necrosis and perforation.
  • Viral etiologies are rarely identified in pediatric GBA-AC.

Purpose of the Study:

  • To report a rare case of acute viral acalculous cholecystitis in a pediatric patient.
  • To identify the specific viral agent responsible for the condition.
  • To describe the diagnostic approach and management outcome.

Main Methods:

  • Case presentation of a 2.5-year-old female child with abdominal symptoms.
  • Laboratory investigations including liver function tests and serology for viral hepatitis.
  • Abdominal ultrasonography to evaluate the gallbladder.

Main Results:

  • The patient presented with fever, vomiting, and abdominal pain.
  • Elevated liver enzymes and hyperbilirubinemia were noted, with no bacterial or parasitic infection.
  • Hepatitis A virus infection was confirmed serologically.
  • Ultrasonography showed a distended, inflamed gallbladder without stones.
  • The child improved with conservative management.

Conclusions:

  • Hepatitis A virus can cause acute acalculous cholecystitis in children.
  • Early diagnosis and conservative management can be effective.
  • This case underscores the importance of considering viral etiologies in pediatric GBA-AC.

Keywords:
Acalculous cholecystitisGallbladder thickeningHepatitis APericholecystic fluid

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