Nossa Senhora da Gloria Children's Hospital, Rua Mary Ubirajara 205, Vitoria, Brazil.
Pediatr Radiol. 2010 May;40(5):720-4. doi: 10.1007/s00247-009-1489-x. Epub 2009 Dec 15.
Dengue fever (DF) is an acute infection caused by a flavivirus. Although most patients present mild symptoms, some progress to a severe condition characterized by hypovolemic shock and hemorrhagic phenomena. The main feature of this severe form of DF is plasma leakage. Gallbladder wall thickening (GBWT), ascites and pleural effusion represent the sonographic triad of plasma leakage in DF.
To evaluate the plasma leakage triad in severe DF with emphasis on the GBWT.
Thirty-seven children with severe DF underwent abdominal US on the day of admittance and on the day of discharge, or 7 days after the first examination if the child was still hospitalized.
Of the 37 children, 33 (89.2%) presented GBWT, 29 (78.4%) ascites and 26 (70.3%) pleural effusion. All of these findings had resolved by the second examination. Of the 33 GBWTs, 29 (87.9%) presented a reticular pattern, which could be considered typical of plasma leakage in patients with severe DF.
GBWT, ascites and pleural effusion are transient findings in DF. The authors have described a typical reticular pattern of GBWT that can be used to diagnose and follow up on patients with severe DF and should not be considered an acalculous cholecystitis.
登革热（DF）是由黄病毒引起的急性感染。尽管大多数患者表现为轻症，但有些患者会进展为以低血容量性休克和出血现象为特征的严重疾病。这种严重形式 DF 的主要特征是血浆渗漏。胆囊壁增厚（GBWT）、腹水和胸腔积液代表 DF 中血浆渗漏的三联征。
用强调 GBWT 的方法来评估严重 DF 中的血浆渗漏三联征。
37 例重症 DF 患儿在入院当天和出院当天，或如果患儿仍住院则在首次检查后第 7 天进行腹部超声检查。
37 例患儿中，33 例（89.2%）有 GBWT，29 例（78.4%）有腹水，26 例（70.3%）有胸腔积液。所有这些发现均在第二次检查时得到解决。33 例 GBWT 中，29 例（87.9%）呈网状模式，这可被认为是重症 DF 患者中血浆渗漏的典型表现。
GBWT、腹水和胸腔积液是 DF 的一过性表现。作者描述了一种典型的网状 GBWT 模式，可用于诊断和随访重症 DF 患者，不应将其视为非结石性胆囊炎。
