Ozaras Resat, Mert Ali, Yilmaz Mehmet Halit, Celik Aygul Dogan, Tabak Fehmi, Bilir Muammer, Ozturk Recep
Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, 34303 Cerrahpasa, Istanbul, Turkey.
J Clin Gastroenterol. 2003 Jul;37(1):79-81. doi: 10.1097/00004836-200307000-00020.
Acute hepatitis A virus (HAV) infection is frequent in developing countries. Although some gallbladder abnormalities are defined during the course, an acute cholecystitis is extremely rare. We here report 2 additional cases of cholecystitis due to acute HAV infection and review the previously reported 2 cases. One of our patients was admitted with jaundice and a suspicious portal mass with a presumed diagnosis of cholagiocarcinoma. The other presented with jaundice, abdominal pain, and constitutional symptoms. Both patients were planned to be operated on. During the follow-up, absence of fever, leukocytosis, acute-phase protein response, and calculus in biliary system were against the diagnosis of a bacterial cholecystitis. Moreover the course of cholecystitis was closely parallel to that of the HAV infection. Both patients were managed conservatively. It was concluded that rare, acute viral cholecystitis can develop during the course of acute HAV infection.
急性甲型肝炎病毒(HAV)感染在发展中国家很常见。虽然在病程中会发现一些胆囊异常,但急性胆囊炎极为罕见。我们在此报告另外2例因急性HAV感染导致的胆囊炎病例,并回顾之前报道的2例病例。我们的一名患者因黄疸和可疑的门静脉肿块入院,初步诊断为胆管癌。另一名患者表现为黄疸、腹痛和全身症状。两名患者都计划接受手术。在随访期间,无发热、白细胞增多、急性期蛋白反应以及胆道系统结石,这些均不支持细菌性胆囊炎的诊断。此外,胆囊炎的病程与HAV感染的病程密切平行。两名患者均接受保守治疗。结论是,在急性HAV感染过程中可能会发生罕见的急性病毒性胆囊炎。