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Cholecystitis as a cause of abdominal pain in patients with acute viral hepatitis A and B
Miodrag Radunović1, Dragica Terzić1, Boban Mugoša2, Zoran Terzić1, Bogdanka Andrić1, Marina Ratković1 and Miroslav Radunovic1
Faculty of Medicine, Podgorica, Montenegro1
Public Health Institute, Podgorica, Montenegro2
Acute cholecystitis is an inflammation of the gallbladder wall, usually caused by gallstones in the cystic duct, which causes attacks of severe pain. At least 95% of the population with acute inflammation of the gallbladder have gallstones. Acute viral hepatitis is the liver inflammation accompanied by nausea, faintness, vomiting, pain below the right rib arch, jaundice. The presence of acute cholecystitis intensifies the existing symptoms.
The aim of the paper was to show the incidence of the gallbladder inflammation in patients with acute hepatitis A or B.
This retrospective-prospective study involved 110 patients treated for viral hepatitis A or B and had severe abdominal pain during hospitalization.
The selected sample involved more male examinees - 63 (62%) compared to female ones - 47 (38%). The most frequent age of examinees was 30-50 years, 82 (83%), and cholecystitis during hepatitis was also most common in the age group 30-50 years, 28 (73%) patients. Cholecystitis was more common in patients with acute hepatitis B - 21 (55%) examinees than in patients with acute hepatitis A - 17 (45%) examinees. Ultrasound examination, performed in 24 (63%) examinees showed gallstones in inflamed gallbladder, while 14 (37%) examinees had the inflammation of the gallbladder without gallstones.
The most common cause of severe abdominal pain in patients with acute liver infection caused by HAV and HBV infection was the gallbladder, 38 (34.5%) patients. Cholecystitis was more common in patients with acute hepatitis B, 21 (55%) examinees, than in those with an acute hepatitis A, 17 (45%) examinees. Acta Medica Medianae 2012; 51(1):20-23.
Key words: cholecystitis, abdominal pain, viral hepatitis A, viral hepatitis B