title: Acalculous gallbladder distension in a young child due to HAV infection: Diagnostic dilemma.
abstract: Gall bladder distension with acute viral acalculous cholecystitis is a rare event in pediatric cases with a high incidence of perforation, gallbladder necrosis and mortality. We report a two and a half year old female child presenting with fever, vomiting, pain abdomen, mild hepatosplenomegaly and tenderness in right hypochondrium. Laboratory investigations revealed hyperbilirubinemia and elevated alkaline phosphatase, but there was no evidence of bacterial or parasitic infection. Serology for viral hepatitis suggested acute Hepatitis A infection. Ultrasonographically, distended inflamed gallbladder without calculous was observed. Finally acute acalculous cholecystitis due to Hepatitis A virus was diagnosed and the child responded to the conservative management.
authors.affiliation: Department of Biochemistry, Sri Siddhartha Medical College, Tumkur-07, India  ; 3/1, Seethappa layout, 5th Block, Doddabommasandra, Vidyaranyapura. P.O, Bangalore, Karnataka 560097 India.
authors.forename: D R
authors.initials: DR
authors.lastname: Suresh
authors.forename: R
authors.initials: R
authors.lastname: Srikrishna
authors.forename: S K
authors.initials: SK
authors.lastname: Nanda
authors.forename: V
authors.initials: V
authors.lastname: Annam
authors.forename: K
authors.initials: K
authors.lastname: Sunil
authors.forename: B
authors.initials: B
authors.lastname: Arjun
keywords: Acalculous cholecystitis; Gallbladder thickening; Hepatitis A; Pericholecystic fluid