Transient gallbladder wall thickening in pediatric acute hepatitis: A case series

Introduction

Transient gallbladder wall thickening is an uncommon sonographic finding in pediatric patients diagnosed with acute hepatitis. It may mimic primary gallbladder pathology such as cholecystitis, potentially leading to unnecessary surgical procedures.

Clinical presentation

Four pediatric patients between the ages of 4 and 8 years presented with acute viral hepatitis and symptoms of abdominal pain, jaundice, and fatigue. The first patient was a 5-year-old girl whose initial ultrasound showed gallbladder wall thickening of 5.6 mm. Follow-up ultrasound 7 weeks later revealed a reduction of the thickness to 1.8 mm. The second patient was a 4-year-old girl who had epigastric pain and dark urine. Ultrasound revealed gallbladder wall thickening of 5.1 mm, which decreased to 0.9 mm on the follow-up ultrasound done after 7 weeks. The third patient was an 8-year-old boy who presented with jaundice and abdominal discomfort. His gallbladder wall measured 5.7 mm initially and decreased to 2.2 mm after 7 weeks. The fourth patient was an 8-year-old boy who had gallbladder wall thickening of 7.0 mm, which on follow-up imaging 4 weeks later had decreased to 3.0 mm. All patients were managed conservatively, without any surgical intervention.

Conclusion

Children with acute viral hepatitis can develop transient gallbladder wall thickening, which typically self-resolves within a few weeks and does not require any specific intervention.