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Acute hepatitis

Case contributed by Mark Hall
Diagnosis almost certain

Presentation

Intravenous drug user attending with painless jaundice and hepatomegaly. Previous deep vein thrombosis. Deranged LFTs ?thrombus ?malignancy.

Patient Data

Age: 30 years
Gender: Female
mri

There is severe gallbladder wall T2 hyperintensity in keeping with edema, which compresses the mucosa of the gallbladder. 

Cystic duct, CBD pancreatic duct are within normal limits with no obstructing lesions seen.
Marked high T2 signal is also demonstrated within the periportal spaces consistent with edema.

Liver also appears slightly enlarged with recanalization of the umbilical vein noted.  
Overall findings suggestive of acute hepatitis and could account for the markedly deranged LFTs.

Case Discussion

This case demonstrates markedly abnormal gallbladder wall and periportal edema with a normal CBD. Appearances suggest acute hepatitis. Full viral hepatitis screen was carried out and found to be negative. The patient then absconded from the ward.

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