Acute Acalculous Cholecystitis Induced by Acute Hepatitis B Virus Infection

Abstract

During the course of acute viral hepatitis, some functional and anatomical changes to the gallbladder can occur. Acute acalculous cholecystitis (ACC) is a rare complication of acute hepatitis B virus infection; only few cases are reported as ACC associated with acute hepatitis B virus infection. ACC cases are self-limiting, while other limited cases can progress to a gangrenous state, perforation, and even death. We present a 27-year-old female case diagnosed to have acute acalculous cholecystitis and associated with acute hepatitis B virus infection, and she recovered within one week of her presentation without complication or surgical intervention.

Acute acalculous cholecystitis caused by Hepatitis C: A rare case report

“…The most widely accepted hypothesis is ischemic injury of the gallbladder cells secondary to immune complex deposition, particularly in cases of ACC associated with hepatitis B virus infection [12] . This hypothesis is supported by the fact that up to 20% of acute hepatitis B patients develop extrahepatic complications secondary to immune complex deposition [18] .…”

“…In addition to ischemic injury, cholecystokinin (CCK), an important hormone secreted after meals, could also play a role in the pathogenesis of AAC. CCK stimulates the gallbladder to contract and release the stored bile into the duodenum, which helps the emulsification of fatty food [18] . This action protects the gallbladder from the detergent effect of bile, which could lead to epithelial injury in cases of prolonged exposure [17] .…”

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“…However, this is extremely rare, appearing to have a milder course and extremely low mortality. 3 After a thorough search in the literature we found two reports of acute hepatitis A associated with pancreatitis and cholecystitis, 18,19 two cases of acute non-fulminant viral hepatitis E, presenting with acute pancreatitis 20,21 and a systematic review about Epstein-Barr virus infection causing pancreatitis and cholecystitis. 22 In the present case, we observed a rare occurrence of acute viral hepatitis B associated with acute pancreatitis and acute cholecystitis, which also had clinical improvement with conservative management.…”

“…2 Acalculous cholecystitis and pancreatitis are rare extra-hepatic complications of acute HBV infection that may be a differential diagnosis of abdominal pain in these patients. [3][4][5]…”

Evrópufaraldur lifrarbólgu A á Íslandi árið 2017. Algengar breytingar í gallblöðru á myndgreiningu

“…Lýst hefur verið tilfellum af bráðri gallblöðrubólgu án steina við bráða lifrarbólgu A og við bráða lifrarbólgu B. 1,[12][13][14][15][16][17][18][19] Ástaeðan er ekki vel þekkt en getur verið bjúgur vegna bólgu í aðlaegri lifur en einnig hefur einu tilfelli verið lýst þar sem sýnt var fram á veiruna í gallblöðruvegg, sem gaeti bent til þess að veiran valdi gallblöðrubólgu gegnum íferð í sjálfa gallblöðruna. 1 Breytingar í samdraetti gallblöðru eru líklegar til að hafa áhrif á útlit og meingerð breytinganna en minnkað gallflaeði getur leitt til aukinnar haettu á sýkingu í gallblöðru.…”