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Title: Hepatitis A virus induced acute acalculous cholecystitis diagnosed postoperatively: Case report
Authors: Tabbikha, Omar
Dasuki, Mahmoud
Kanaan, Anthony
Ali, Bader
Hadeer, Ribal Aby
Wakim, Raja
Affiliations: Faculty of Medicine 
Faculty of Medicine 
Faculty of Medicine 
Faculty of Medicine 
Faculty of Medicine 
Faculty of Medicine 
Keywords: Acalculous cholecystitis
Case report
Hepatitis A virus
Laparoscopic cholecystectomy
Issue Date: 2024-04-23
Publisher: Elsevier
Part of: International Journal of Surgery Case Reports
Volume: 119
acute acalculous cholecystitis (AAC) is defined as gallbladder inflammation without the presence of stones. Contrary, hepatitis A virus (HAV) can present with different symptoms; however, HAV causing and presenting as AAC is rare.

Case presentation
41-year-old previously healthy patient presented with right upper quadrant abdominal pain. The pain was persistent and associated with vomiting and laboratory tests showed elevated bilirubin. Laparoscopic cholecystectomy showed inflamed gallbladder with no stones and intraoperative cholangiography showed no abnormalities. Day one post-operation, while the pain resolved, labs showed elevated liver function tests and hepatitis workup showed acute HAV infection attributing her presentation to HAV induced AAC.

AAC is usually caused by stasis of the gallbladder due to different causes; however, HAV induced AAC has been rarely reported. While cholecystectomy is the mainstay treatment for AAC, this might not be the case for HAV induced AAC. For instance, unless there is necrotic gallbladder or persistence of symptoms, AAC can be managed conservatively in this case. Even though our diagnosis was cleared post-operatively, had we knew the diagnosis of HAV induced AAC before, we would have still opt for surgery due to the severity and persistence of pain.

More cases should be reported and more studies should be done to further define the presentation and management of HAV induced AAC.
ISSN: 2210-2612
DOI: 10.1016/j.ijscr.2024.109687
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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