|
1
|
González Díaz I, Abadía Barnó M, Amor Costa C, Amiama Roig C. Acute acalculous cholecystitis secondary to hepatitis A infection. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024. [PMID: 39588963 DOI: 10.17235/reed.2024.10941/2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
Acute acalculous cholecystitis (AAC) of infectious origin represents a small percentage of all cases of cholecystitis. According to the literature, the most common pathogens include Salmonella typhii and Epstein-Barr virus (EBV). However, AAC has also been described as a rare complication in the context of other viral hepatitis infections, with only a few reported cases attributed to hepatitis A virus (HAV) infection. We present the case of a patient with AAC secondary to HAV infection, which resolved favorably with conservative management. We report the case of a 29-year-old male presenting with jaundice, abdominal pain, and fever lasting three days. Laboratory results revealed elevated transaminase levels with a cholestatic pattern and hyperbilirubinemia, predominantly direct bilirubin. Abdominal ultrasound showed a gallbladder with a thickened, heterogeneous, poorly defined, and disorganized wall, along with multiple enlarged perihilar lymph nodes and a positive Murphy's sign. Serological testing for hepatopathy revealed positive IgM antibodies for HAV, confirming the diagnosis of hepatitis A. Seven days later, follow-up testing demonstrated normalization of both laboratory parameters and ultrasound findings following resolution of the viral illness.
Collapse
|
|
2
|
Wu J, Wang H, Xiang Z, Jiang C, Xu Y, Zhai G, Ling Z. Role of viral hepatitis in pregnancy and its triggering mechanism. J Transl Int Med 2024; 12:344-354. [PMID: 39360164 PMCID: PMC11444475 DOI: 10.2478/jtim-2024-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024] Open
Abstract
Hepatitis viral infection can cause severe complications, even mortality in pregnant women and their offspring. Multiple studies have shown that vertical transmission can cause viral hepatitis infections in newborns, especially in hepatitis B, C, and E. Screening for hepatitis viral infection in pregnant women is essential. Once infected, pregnant women should be given timely antiviral treatments, which could effectively alleviate the disease progression and reduce adverse outcomes. Besides, the mechanism of viral hepatitis mediating adverse pregnancy outcomes has been a hot topic. Hepatitis B virus has been found to mediate both mother- to-child and parent-child transmission. Liver injury in hepatitis C virus infection is associated with immune-mediated mechanisms, which can be regulated by hormonal factors as well. The mediating mechanism of adverse maternal and infant outcomes caused by hepatitis E virus infection is mainly related to viral replication in the placenta and changes in cytokine and estrogen. Nevertheless, the specific mechanisms related to hepatitis A virus and hepatitis D virus remain unclear, and more research is needed. This review shows that the existence of viral hepatitis during pregnancy can pose certain risks for pregnant women and infants, and different interventions have been used to treat pregnant women infected with viral hepatitis. It may provide deep insight into adverse pregnancy outcomes caused by viral hepatitis and give guidance on treatment.
Collapse
Affiliation(s)
- Jian Wu
- Department of Blood Transfusion, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 242 Guangji Road, Suzhou 215008, Jiangsu Province, China
| | - Huiqing Wang
- Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
| | - Ze Xiang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, City, Hangzhou 310003, Zhejiang Province, China
| | - Chun Jiang
- Department of Blood Transfusion, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 242 Guangji Road, Suzhou 215008, Jiangsu Province, China
| | - Yunyang Xu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, City, Hangzhou 310003, Zhejiang Province, China
| | - Guanghua Zhai
- Department of Blood Transfusion, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 242 Guangji Road, Suzhou 215008, Jiangsu Province, China
| | - Zongxin Ling
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, City, Hangzhou 310003, Zhejiang Province, China
| |
Collapse
|
|
3
|
Chang C, Wang Y, Shi W, Xu H, Huang X, Jiao Y. Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen? Medicine (Baltimore) 2023; 102:e34662. [PMID: 37656996 PMCID: PMC10476726 DOI: 10.1097/md.0000000000034662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/19/2023] [Indexed: 09/03/2023] Open
Abstract
Patients with acute acalculous cholecystitis (AAC) often present with acute abdominal symptoms. However, recent clinical studies have suggested that some patients with AAC and an acute abdomen, especially when caused by viruses or rheumatic disease, may not require cholecystectomy and that conservative treatment is adequate. Whether cholecystectomy is superior to conservative treatment for patients with AAC presenting with a severe acute abdomen is still uncertain. This was a case series study of AAC-related literature published between 1960 and 2022. In total, 171 cases (104 viral infection-associated AAC and 67 rheumatic disease-associated AAC) were included. The prognoses of patients receiving cholecystectomy or conservative treatment were compared. To account for confounding factors, etiological stratification and logistic regression were performed. The prognosis was similar for patients undergoing cholecystectomy and conservative treatment (P value .364), and virus infection-associated AAC had a better prognosis than rheumatic disease-associated AAC (P value .032). In patients with AAC caused by viruses or rheumatic disease, the acute abdomen can be adequately managed by conservative treatment of the underlying etiology and does not mandate surgical intervention.
Collapse
Affiliation(s)
- Chuheng Chang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Youyang Wang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wen Shi
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Haifeng Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoming Huang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Jiao
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
|
4
|
Cao X, Jiang W, Shi L, Wang Y, Chen J, Huang W, Zhang S. Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition. Virol J 2023; 20:77. [PMID: 37095526 PMCID: PMC10124029 DOI: 10.1186/s12985-023-02045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND This study aimed to understand the incidence and clinical significance of acalculous cholecystitis in patients with acute hepatitis E (HE). PATIENTS AND METHODS A single center enrolled 114 patients with acute HE. All patients underwent imaging of the gallbladder, and patients with gallstones and cholecystectomy were excluded. RESULTS Acalculous cholecystitis was found in 66 patients (57.89%) with acute HE. The incidence in males was 63.95%, which was significantly higher than in females (39.29%) (P = 0.022). The mean length of hospital stay and the incidence of spontaneous peritonitis in patients with cholecystitis (20.12 ± 9.43 days and 9.09%, respectively) were significantly higher than those in patients without cholecystitis (12.98 ± 7.26 days and 0%, respectively) (P < 0.001 and P = 0.032). Albumin, total bile acid, bilirubin, cholinesterase, and prothrombin activity in patients with cholecystitis were significantly inferior to those in patients without cholecystitis (P < 0.001, P < 0.001, P < 0.001, P < 0.001 and P = 0.003, respectively). After correction by multivariate analysis, albumin and total bile acid were found to be closely related to acalculous cholecystitis in HE. CONCLUSION Acalculous cholecystitis is very common in patients with acute HE, and may serve as a predictor of increased peritonitis, synthetic decompensation, and longer hospital stay.
Collapse
Affiliation(s)
- Xuemei Cao
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Wei Jiang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Lingfeng Shi
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
- Department of Infectious Diseases, Youyang Hospital, A Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanping Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Chen
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Wenxiang Huang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Shujun Zhang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
| |
Collapse
|
|
5
|
Salajegheh F, Shafieipour S, Najminejad Z, Pourzand P, Nakhaie M, Jahangiri S, Sarmadian R, Gilani A, Rukerd MRZ. HAV-induced acalculous cholecystitis: A case report and literature review. Clin Case Rep 2023; 11:e7254. [PMID: 37113636 PMCID: PMC10127462 DOI: 10.1002/ccr3.7254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/02/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Hepatitis A virus (HAV) has some life-threatening extrahepatic complications, such as acute acalculous cholecystitis (AAC). We present HAV-induced AAC in a young female, based on clinical, laboratory, and imaging findings, and conduct a literature review. The patient became irritable, which progressed to lethargy, as well as a significant decline in liver function, indicating acute liver failure (ALF). She was immediately managed in the intensive care unit with close airway and hemodynamic monitoring after being diagnosed with ALF (ICU). The patient's condition was improving, despite only close monitoring and supportive treatment with ursodeoxycholic acid (UDCA) and N-acetyl cysteine (NAC).
Collapse
Affiliation(s)
- Faranak Salajegheh
- Clinical Research Development Unit, School of MedicineAfzalipour Hospital, Kerman University of Medical SciencesKermanIran
| | - Sara Shafieipour
- Physiology Research Center, Institute of NeuropharmacologyKerman University of Medical SciencesKermanIran
| | - Zohre Najminejad
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology SciencesKerman University of Medical Sciences KermanKermanIran
| | - Pouria Pourzand
- School of MedicineZahedan University of Medical SciencesZahedanIran
| | - Mohsen Nakhaie
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology SciencesKerman University of Medical SciencesKermanIran
| | - Samaneh Jahangiri
- Clinical Research Development Unit, School of MedicineAfzalipour Hospital, Kerman University of Medical SciencesKermanIran
| | - Roham Sarmadian
- Infectious disease research centerArak University of Medical SciencesArakIran
| | - Abolfazl Gilani
- Department of pediatric surgeryTehran university of Medical SciencesTehranIran
| | - Mohammad Rezaei Zadeh Rukerd
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology SciencesKerman University of Medical SciencesKermanIran
| |
Collapse
|
|
6
|
Chang CH, Wang YY, Jiao Y. Hepatitis A virus-associated acute acalculous cholecystitis in an adult-onset Still’s disease patient: A case report and review of the literature. World J Clin Cases 2023; 11:1410-1418. [PMID: 36926135 PMCID: PMC10013114 DOI: 10.12998/wjcc.v11.i6.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/14/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Acute acalculous cholecystitis (AAC) is inflammation of the gallbladder without evidence of calculi. Although rarely reported, its etiologies include hepatitis virus infection (e.g., hepatitis A virus, HAV) and adult-onset Still’s disease (AOSD). There are no reports of HAV-associated AAC in an AOSD patient.
CASE SUMMARY Here we report a rare case of HAV infection-associated AAC in a 39-year-old woman who had a history of AOSD. The patient presented with an acute abdomen and hypotension. Elevated hepatobiliary enzymes and a thickened and distended gallbladder without gallstones on ultrasonography suggested AAC, but there were no signs of anemia nor thrombocytopenia. Serological screening revealed anti-HAV IgM antibodies. Steroid treatment did not alleviate her symptoms, and she was referred for laparoscopic cholecystectomy. The resected gallbladder was hydropic without perforation, and her clinical signs gradually improved after surgery.
CONCLUSION AAC can be caused by HAV in AOSD patients. It is crucial to search for the underlying etiology for AAC, especially uncommon viral causes.
Collapse
Affiliation(s)
- Chu-Heng Chang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - You-Yang Wang
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yang Jiao
- Department of General Practice (General Internal Medicine), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| |
Collapse
|
|
7
|
Botea F, Kraft A, Popescu I. Pathophysiology and Diagnosis of Acute Acalculous Cholecystitis. DIFFICULT ACUTE CHOLECYSTITIS 2021:21-32. [DOI: 10.1007/978-3-030-62102-5_3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]
|
|
8
|
Acute Acalculous Cholecystitis due to Viral Hepatitis A. Case Rep Infect Dis 2013; 2013:407182. [PMID: 24106622 PMCID: PMC3784234 DOI: 10.1155/2013/407182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 08/06/2013] [Indexed: 12/21/2022] Open
Abstract
Inflammation of the gallbladder without evidence of calculi is known as acute acalculous cholecystitis (AAC). AAC is frequently associated with gangrene, perforation, and empyema. Due to these associated complications, AAC can be associated with high morbidity and mortality. Medical or surgical treatments can be chosen according to the general condition of the patient, underlying disease and agent. Particularly in acute acalculous cholecystitis cases, early diagnosis and early medical treatment have a positive effect on the patient and protect them from surgical trauma. ACC is a rare complication of acute viral hepatitis A. Herein, we present an adult patient of acalculous cholecystitis due to acute viral hepatitis A. She responded to the conservative management.
Collapse
|
|
9
|
Melero Ferrer JL, Ortuño Cortés J, Nevárez Heredia A, Yago Baenas M, Berenguer M. [Acute acalculous cholecystitis associated with acute hepatitis A virus infection]. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 31:433-5. [PMID: 18783688 DOI: 10.1157/13125589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although acute cholecystitis in the context of acute hepatitis A virus (HAV) infection is extremely rare, previous cases have been reported. However, this manifestation of HAV infection is little known. In the present article, we briefly review previously documented cases and present a new case. We report the case of a 39-year-old woman with fever, abdominal pain and moderately elevated transaminase levels who developed jaundice and peritoneal irritation. Diagnosis of acute cholecystitis was given by abdominal ultrasound and magnetic resonance imaging. The patient underwent surgery. In the postoperative period, positive IgM antibody titers for HAV were obtained, confirming the diagnosis of HAV infection.
Collapse
|
|
10
|
Ruiz-Rebollo ML, Sánchez-Antolín G, García-Pajares F, Vallecillo-Sande MA, Fernández-Orcajo P, Velicia-Llames R, Caro-Patón A. Acalculous cholecystitis due to Salmonella enteritidis. World J Gastroenterol 2008; 14:6408-9. [PMID: 19009660 PMCID: PMC2766126 DOI: 10.3748/wjg.14.6408] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Acute acalculous cholecystitis (AAC) is defined as an acute inflammation of the gallbladder in the absence of stones. We herein report a case of a young man who developed AAC after a Salmonella enteritidis gastrointestinal infection.
Collapse
|