Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition

Virol J. 2023 Apr 24;20(1):77. doi: 10.1186/s12985-023-02045-8.

Abstract

Background: This study aimed to understand the incidence and clinical significance of acalculous cholecystitis in patients with acute hepatitis E (HE).

Patients and methods: A single center enrolled 114 patients with acute HE. All patients underwent imaging of the gallbladder, and patients with gallstones and cholecystectomy were excluded.

Results: Acalculous cholecystitis was found in 66 patients (57.89%) with acute HE. The incidence in males was 63.95%, which was significantly higher than in females (39.29%) (P = 0.022). The mean length of hospital stay and the incidence of spontaneous peritonitis in patients with cholecystitis (20.12 ± 9.43 days and 9.09%, respectively) were significantly higher than those in patients without cholecystitis (12.98 ± 7.26 days and 0%, respectively) (P < 0.001 and P = 0.032). Albumin, total bile acid, bilirubin, cholinesterase, and prothrombin activity in patients with cholecystitis were significantly inferior to those in patients without cholecystitis (P < 0.001, P < 0.001, P < 0.001, P < 0.001 and P = 0.003, respectively). After correction by multivariate analysis, albumin and total bile acid were found to be closely related to acalculous cholecystitis in HE.

Conclusion: Acalculous cholecystitis is very common in patients with acute HE, and may serve as a predictor of increased peritonitis, synthetic decompensation, and longer hospital stay.

Keywords: Acalculous cholecystitis; Hepatitis E; Hospital stay; Spontaneous peritonitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acalculous Cholecystitis* / complications
  • Acute Disease
  • Bile Acids and Salts
  • Cholecystitis* / complications
  • Cholecystitis* / epidemiology
  • Female
  • Hepatitis E* / complications
  • Humans
  • Male
  • Peritonitis* / etiology

Substances

  • Bile Acids and Salts