Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report

Hepatitis A virus (HAV) is a viral infection that can present with a wide range of clinical manifestations, including rare complications such as acute acalculous cholecystitis (AAC). We present the case of a 31-year-old woman who arrived at the emergency department with severe epigastric pain, fever...

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Autores principales: Medina Ramirez, Sebastian Andre, Arones-Santayana, Camila A., Carcausto, Eduardo, Diaz Reyes, Nelson Fidel
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Publicado: 2025
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author Medina Ramirez, Sebastian Andre
Arones-Santayana, Camila A.
Carcausto, Eduardo
Diaz Reyes, Nelson Fidel
author_browse Arones-Santayana, Camila A.
Carcausto, Eduardo
Diaz Reyes, Nelson Fidel
Medina Ramirez, Sebastian Andre
author_facet Medina Ramirez, Sebastian Andre
Arones-Santayana, Camila A.
Carcausto, Eduardo
Diaz Reyes, Nelson Fidel
author_sort Medina Ramirez, Sebastian Andre
collection Producción científica
description Hepatitis A virus (HAV) is a viral infection that can present with a wide range of clinical manifestations, including rare complications such as acute acalculous cholecystitis (AAC). We present the case of a 31-year-old woman who arrived at the emergency department with severe epigastric pain, fever, early satiety, nausea, and vomiting. Physical examination revealed a positive Murphy's sign, hepatomegaly, and epigastric tenderness, suggesting obstructive acute cholecystitis. Imaging studies showed reactive changes in the gallbladder and mild dilation of the intrahepatic bile ducts. Laboratory tests indicated elevated bilirubin levels and a cholestatic pattern with markedly increased transaminases. Magnetic resonance cholangiopancreatography confirmed AAC and ruled out biliary obstruction. Positive serology for Hepatitis A led to the definitive diagnosis of AAC secondary to Hepatitis A. Treatment focused on supportive care with intravenous hydration and symptomatic management, avoiding antibiotics due to the self-limiting nature of the viral infection. The patient showed a favorable clinical course, with a progressive decrease in gallbladder diameter and normalization of liver parameters. This case highlights the importance of considering rare viral infections as a cause of AAC and demonstrates that a conservative approach can be effective in managing this condition. This case underscores the importance of considering viral etiologies, particularly HAV, in the differential diagnosis of AAC in adults. It further demonstrates that, in carefully selected patients, conservative management can be both safe and effective, thereby avoiding unnecessary antibiotic use or surgical intervention in the context of a self-limiting viral infection.
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spelling oai:cris.upeu.edu.pe:20.500.15037/11862026-10-30T16:49:05ZConservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case ReportMedina Ramirez, Sebastian AndreArones-Santayana, Camila A.Carcausto, EduardoDiaz Reyes, Nelson FidelHepatitis ACholecystitisAcalculous CholecystitisConservative TherapyHepatitis A virus (HAV) is a viral infection that can present with a wide range of clinical manifestations, including rare complications such as acute acalculous cholecystitis (AAC). We present the case of a 31-year-old woman who arrived at the emergency department with severe epigastric pain, fever, early satiety, nausea, and vomiting. Physical examination revealed a positive Murphy's sign, hepatomegaly, and epigastric tenderness, suggesting obstructive acute cholecystitis. Imaging studies showed reactive changes in the gallbladder and mild dilation of the intrahepatic bile ducts. Laboratory tests indicated elevated bilirubin levels and a cholestatic pattern with markedly increased transaminases. Magnetic resonance cholangiopancreatography confirmed AAC and ruled out biliary obstruction. Positive serology for Hepatitis A led to the definitive diagnosis of AAC secondary to Hepatitis A. Treatment focused on supportive care with intravenous hydration and symptomatic management, avoiding antibiotics due to the self-limiting nature of the viral infection. The patient showed a favorable clinical course, with a progressive decrease in gallbladder diameter and normalization of liver parameters. This case highlights the importance of considering rare viral infections as a cause of AAC and demonstrates that a conservative approach can be effective in managing this condition. This case underscores the importance of considering viral etiologies, particularly HAV, in the differential diagnosis of AAC in adults. It further demonstrates that, in carefully selected patients, conservative management can be both safe and effective, thereby avoiding unnecessary antibiotic use or surgical intervention in the context of a self-limiting viral infection.Articlehttps://pubmed.ncbi.nlm.nih.gov/41425521https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/carm/3446365https://doi.org/10.1155/carm/3446365PMC1271409410.1155/carm/3446365https://hdl.handle.net/20.500.15037/118641425521W4417261644enCase Reports in Medicine1687-96271687-96352025-01-012026-06-13T09:49:22Z2026-06-13T09:49:22Z
spellingShingle Hepatitis A
Cholecystitis
Acalculous Cholecystitis
Conservative Therapy
Medina Ramirez, Sebastian Andre
Arones-Santayana, Camila A.
Carcausto, Eduardo
Diaz Reyes, Nelson Fidel
Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report
title Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report
title_full Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report
title_fullStr Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report
title_full_unstemmed Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report
title_short Conservative Treatment of HAV‐Associated Acalculous Acute Cholecystitis in an Adult: A Case Report
title_sort conservative treatment of hav associated acalculous acute cholecystitis in an adult a case report
topic Hepatitis A
Cholecystitis
Acalculous Cholecystitis
Conservative Therapy
topic_facet Hepatitis A
Cholecystitis
Acalculous Cholecystitis
Conservative Therapy
url https://pubmed.ncbi.nlm.nih.gov/41425521
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/carm/3446365
https://doi.org/10.1155/carm/3446365
https://hdl.handle.net/20.500.15037/1186
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