Aldaghi Mitra, Haghighat Mahmoud, Dehghani Seyed Mohsen
Department of Pediatric Gastroenterology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Jundishapur J Microbiol. 2014 Dec 10;8(1):e15779. doi: 10.5812/jjm.15779. eCollection 2015 Jan.
Acute Hepatitis A Virus (HAV) infection is common in the developing countries among children, but hydrops of gallbladder due to hepatitis A infection is an uncommon presentation.
A five-year-old boy was admitted in Namazi Hospital, Shiraz, Iran due to jaundice and severe abdominal pain for 10 days. Physical examination revealed a mass in the right upper quadrant with severe tenderness. Liver function tests were abnormal while other laboratory data such as blood urea nitrogen, serum creatinine, sodium, and potassium were within the normal range. Blood and urine cultures were negative. Abdominal ultrasonography showed that the gallbladder was very much distended and its fundus was near the iliac crest. Hydrops of the gallbladder was diagnosed. HAV IgM titer was high. After five days, without any specific treatment, his symptoms improved and he was discharged with good condition.
Acute acalculous gallbladder disease is a rare complication of HAV infection which should be suspected in any child with right upper quadrant abdominal pain, tenderness, and mass which can lead to surgical emergency in rare conditions.
急性甲型肝炎病毒(HAV)感染在发展中国家的儿童中很常见,但甲型肝炎感染导致的胆囊积水是一种不常见的表现。
一名五岁男孩因黄疸和严重腹痛10天入住伊朗设拉子的纳马齐医院。体格检查发现右上腹有一个肿块,有严重压痛。肝功能检查异常,而其他实验室数据如血尿素氮、血清肌酐、钠和钾均在正常范围内。血培养和尿培养均为阴性。腹部超声显示胆囊极度扩张,其底部靠近髂嵴。诊断为胆囊积水。HAV IgM滴度很高。五天后,未经任何特殊治疗,他的症状有所改善并康复出院。
急性无结石性胆囊疾病是HAV感染的一种罕见并发症,任何出现右上腹腹痛、压痛和肿块的儿童都应怀疑为此病,在极少数情况下可能导致外科急症。