Correlation of gallbladder wall pathology with controlled attenuation parameter, liver stiffness measurement, and laboratory markers in acute viral hepatitis A.

Abstract

Background: Acute viral hepatitis A remains a significant public health concern.

Objective: This study investigated the relationship between gallbladder wall pathology, liver stiffness measurements, controlled attenuation parameter, and biochemical markers in adult patients with acute viral hepatitis A.

Methods: Overall, 42 patients with acute viral hepatitis A were studied over 3 months. Patients underwent ultrasound and transient elastography examinations. Gallbladder wall thickness was categorised into two groups: 3-10 mm (group A) and ⩾10 mm (group B).

Results: Gallbladder wall thickening was detected in 95% of patients. Stratification and fluid accumulation were present in 71% and 38% of patients, respectively. Gallbladder wall thickness ⩾10mm was significantly associated with stratification and fluid accumulation (p < 0.0001). Higher gallbladder wall thickness correlated with elevated alanine aminotransferase (p = 0.008), ammonia levels (p = 0.011), and international normalised ratio (p = 0.047). A positive correlation was observed between procalcitonin levels ⩾0.25 ng/mL and gallbladder wall thickness ⩾10 mm (p = 0.011). The controlled attenuation parameter values were significantly lower in patients with greater gallbladder wall thickness (p = 0.013), while liver stiffness measurement showed no correlation with gallbladder wall thickness.

Conclusion: In acute viral hepatitis A, gallbladder wall thickening is almost a pathognomonic finding. Increased gallbladder wall thickness correlates with increased alanine aminotransferase, ammonia, international normalised ratio, and procalcitonin levels, highlighting its potential as a non-invasive marker of disease severity. Controlled attenuation parameter and liver stiffness measurement require cautious interpretation in acute inflammation. These findings support gallbladder wall assessment as a valuable tool in evaluating acute viral hepatitis A.