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Gallbladder and pancreatic involvement in hepatitis A

A Klar1, D Branski, M Nadjari

  • 1Department of Pediatrics, Bikur Cholim General Hospital, Jerusalem, Israel.

Insights

Hepatitis A virus infection in children can cause gallbladder abnormalities, including thickened walls. Awareness of these findings is crucial for pediatricians and surgeons to prevent unnecessary procedures.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Diagnostic Imaging

Background:

  • Gallbladder (GB) abnormalities are uncommon in pediatric populations.
  • GB involvement is recognized in various inflammatory conditions.
  • Hepatitis A virus (HAV) infection is a common cause of acute hepatitis in children.

Purpose of the Study:

  • To investigate the prevalence and sonographic characteristics of gallbladder abnormalities in children hospitalized with hepatitis A virus infection.
  • To highlight potential pancreatic and ascitic fluid involvement associated with HAV infection in pediatric patients.

Main Methods:

  • Retrospective ultrasound evaluation of 39 children hospitalized with confirmed hepatitis A virus infection.
  • Assessment of gallbladder wall thickness, echogenicity, and presence of striations.
  • Evaluation for associated pancreatic findings and ascites.

Main Results:

  • Gallbladder wall thickening (pseudosurgical gallbladder wall) of ≥10 mm with striation was observed in 10 out of 39 children (25.6%).
  • Pathological echographic findings in the pancreas were noted in three patients, including one with clinical pancreatitis.
  • Ascitic fluid was detected in eight patients.

Conclusions:

  • Hepatitis A virus infection can manifest with significant gallbladder wall abnormalities in children.
  • Pediatricians and surgeons should be aware of these potential GB and pancreatic findings in HAV infection.
  • Recognition of these ultrasound findings may help avoid misdiagnosis and unnecessary surgical interventions.

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