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Acute hepatitis

Case contributed by Naim Qaqish
Diagnosis almost certain

Presentation

Epigastric pain presenting through A&E.

Patient Data

Age: 30 years
Gender: Female

Abdomen

ultrasound

The liver appears slightly hypoechoic and enlarged measuring 20 cm in MCL.

Amorphous appearance of the gallbladder depicting markedly thickened wall with pericholecystic edema. No stones are seen.

The CBD is normal in caliber measuring 3 mm. No intrahepatic biliary ductal dilatation.

The spleen is enlarged and measures 14.5 cm.

The portal vein is patent.

The pancreas and both kidneys are normal and no ascites is seen.

Case Discussion

A 30-year-old lady presented through the emergency room with epigastric pain, dark urine, pale stool, and labs showing elevated bilirubin levels. Abdomen ultrasound was requested demonstrating diffusely enlarged hypoechoic liver, with thickened gallbladder wall, pericholecystic fluid and mild splenomegaly. Although non-specific, findings are suggestive of acute hepatitis. Laboratory assessment is recommended for confirmation.

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