Prognostic value of gallbladder wall thickening in patients with acute hepatitis A

PURPOSE To investigate the clinical significance of gallbladder (GB) wall thickening frequently observed in patients with acute hepatitis A. METHODS A total of 328 consecutive patients who were diagnosed with acute hepatitis A and underwent abdominal ultrasonography were enrolled retrospectively. Patients were divided into two groups: GB wall thickening (≥3 mm, group A) and no thickening (group B). Group A was subdivided into two subgroups (GB wall thickening of ≥10 mm, group A-1 and ≥3 mm to <10 mm, group A-2). The laboratory results related to liver function, hospitalization duration, and time to normalization of liver function were compared between the groups. RESULTS A total of 230 patients showed GB wall thickening (group A). Besides gamma-glutamyl transpeptidase and alkaline phosphatase, all laboratory results of group A were significantly higher than those of group B (P<0.05). Compared with group B, the hospitalization duration and the time to normalization of liver function were significantly longer in group A (P<0.05). Group A-1 included 146 patients and group A-2 included 84 patients. No significant differences in laboratory results, hospitalization duration, and time to normalization of liver function were found between the two subgroups. In the multivariate logistic regression analysis, serum alanine transaminase, total bilirubin and albumin levels, and hospitalization duration were significantly associated with GB wall thickening in patients with hepatitis A. CONCLUSION The presence of GB wall thickening in patients with acute hepatitis A suggests a poorer prognosis irrespective of the degree of GB wall thickening or the degree of liver enzyme elevation.