Presentation
Abdominal pain, diarrhea, pale stool and dark urine.
Patient Data
The liver shows periportal thickening with starry sky appearance. Otherwise, it appears normal in size without evidence of focal lesion or biliary tree dilatation.
The gallbladder shows diffuse wall thickening.
Case Discussion
Laboratory findings included positive HAV AB IgM and elevated ALT, AST and clinical picture were consistent with the diagnosis of acute hepatitis A Hepatitis.
Starry sky appearance is a nonspecific sign that is encountered in many entities including:
Acute hepatitis (viral, parasitic)
Toxic shock syndrome
Neoplastic involvement (Burkitt's lymphoma, leukemia)
Fasting liver with depleted glycogen stores
Drug-induced, alcoholic
Autoimmune
Radiation
NASH (NonAlcoholic SteatoHepatitis)
Twin–twin transfusion
Diffuse gallbladder wall thickening is a result of many etiologies, hepatitis is considered one of the causes.
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