Sonographic findings of acute hepatitis in the emergency department

Viral hepatitis is a common cause of upper abdominal pain, vomiting, and abnormal liver function tests. In 2018, there was an outbreak of hepatitis A cases in southwestern Ohio, one of many across the United States in recent years. Viral hepatitis can demonstrate impressive gallbladder wall edema and thickening on ultrasound imaging. We describe a case series where marked gallbladder wall thickening was noted on point-of-care ultrasound and either led to the correct diagnosis or prompted some diagnostic uncertainty. In an undifferentiated patient, this may confuse the clinical picture because most emergency physicians may not be aware of this finding.