Multi-septate gallbladder: An unusual sonographic pattern in acute hepatitis

✍ Scribed by Kong, Man-Shan; Wong, Ho-Fai

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 367 KB
• Volume: 24
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/(sici)1097-0096(199602)24:2<86::aid-jcu7>3.0.co;2-g

✦ Synopsis

In acute hepatitis, ultrasonography of the gallbladder usually shows wall thickening.lP3 We present a child with acute hepatitis whose gallbladder showed multi-septations sonographically.

CASE REPORT

A 9-year-old boy was admitted because of general malaise, nausea, vomiting, tea color urine, and jaundice for 3 days. There was neither drug nor toxin-exposure history. The patient was previously in good health. On admission, his liver was palpable 4-cm below the right costal margin. Tenderness was present in the right upper abdomen.

Laboratory studies showed that the hemoglobin was 13.3 g/dL; white blood cell count, 4,800/ mm3; aspartate aminotransferase (AST), 898 U/L (normal, 10-35); alanine aminotransferase (ALT), 1343 U/L (normal, 15-40); gammaglutamyl transpeptidase, 48 U/L (normal; 0-26); direct bilirubin, 2.9 mg/dL; total bilirubin, 6.3 mg/dL; albumin, 3.7 g/dL; globulin 3.6 g/dL; and blood urea nitrogen, 11 mg/dL. Hepatitis marker studies, including hepatitis A, B, and C, cytomegalovirus, Epstein-Barr virus, and herpes simplex virus, were all negative.

An abdominal sonogram revealed multiple linear and focal areas of lucencies mixed with nonshadowing echogenic densities within the gallbladder (Figure lA, 1B). A follow-up sonogram after a fatty meal showed the same features, sug-