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Enterically transmitted non-A, non-B hepatitis mimicking acute cholecystitis
1Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi.
The American Journal of Gastroenterology
|May 1, 1995
Summary
Certain patients with enterically transmitted non-A, non-B hepatitis exhibit acute cholecystitis-like symptoms and thickened gallbladder walls. These cases resolve with conservative treatment, and gallbladder wall thickness normalizes within six weeks.
Area of Science:
- Hepatology
- Gastroenterology
- Diagnostic Imaging
Background:
- Acute viral hepatitis (AVH) can present with varied clinical and sonographic findings.
- Cholecystitis-like symptoms and gallbladder wall thickening (GBWT) are not typically associated with AVH.
Purpose of the Study:
- To investigate the significance of cholecystitis-like presentation and increased GBWT in patients with AVH.
- To evaluate the clinical course and sonographic resolution in these patients.
Main Methods:
- Prospective study of 67 patients with AVH (Hepatitis A, B, and ET-NANB).
- Weekly clinical assessment and ultrasound evaluation of GBWT until recovery.
- Comparison of GBWT between AVH subtypes and with controls.
Main Results:
- 22 ET-NANB hepatitis patients presented with acute cholecystitis-like features and significantly higher mean GBWT (10.18 mm) compared to other AVH patients (p < 0.001).
- Mean GBWT in all AVH patients (7.31 mm) was significantly higher than controls (1.76 mm) (p < 0.001).
- All patients with cholecystitis-like presentation recovered with conservative management, and GBWT normalized within 6 weeks.
Conclusions:
- A subset of ET-NANB hepatitis patients can mimic acute cholecystitis with thickened gallbladder walls.
- These cases demonstrate favorable outcomes with conservative management and transient sonographic abnormalities.