Hepatitis viruses have a strong tropism for hepatocytes; viral antigen also has been detected in pancreas and gallbladder. Acute pancreatitis is common in Fulminant hepatic failure but rarely reported in acute viral hepatitis.
124 patients with acute viral hepatitis over a three year period were involved. Acute abdominal pain was present in 24 patients, 7 had acute pancreatitis and 17 had stretching of glissons capsule as a cause. The etiology of pancreatitis was hepatitis E virus in 4 patients, hepatitis A virus in 2 and hepatitis B virus in 1.
A research article to be published on November 21 in the World Journal of Gastroenterology addresses the above issue. The research team led by Dr. Pankaj Jain and Dr. Sandeep Nijhawan from Sawai Man Singh College and Hospital, Jaipur worked on patients with acute viral hepatitis who had severe acute abdominal pain for more than three years. The large sample size allowed them to obtain significant results and draw very reliable conclusions.
Only a few case reports and one case series of symptomatic pancreatitis in the setting of acute viral hepatitis have been reported. In this study 5.65% of patients had acute mild pancreatitis. All patients recovered on conservative management with no complications and sequelae on mean follow-up of 12 (range 8-24) months.
Patients with acute viral hepatitis with severe abdomen pain should undergo serum amylase, lipase and ultrasonography or contrast-enhanced computed tomography of the abdomen to prove acute pancreatitis as a cause of abdomen pain.
Hepatitis E virus, hepatitis B virus and hepatitis A virus were the cause of acute viral hepatitis in 54, 54 and 16 patients, respectively. They are preventable if high-risk groups and health professionals are immunized, there is proper sanitation, screening of the blood products and precautionary measures are taken to prevent their spread.
Dr. Pankaj Jain (doing a fellowship in gastroenterology) and Dr. Sandeep Nijhawan (Professor of Gastroenterology) are working in Department of Gastroenterology at Sawai Man Singh College and Hospital, Jaipur.
The article describes the clinical findings of acute pancreatitis in acute viral hepatitis. The main content of the manuscript is good.
Reference: Jain P, Nijhawan S, Rai RR, Nepalia S, Mathur A. Acute pancreatitis in acute viral hepatitis. World J Gastroenterol 2007; 13(43): 5741-5744. http://www.wjgnet.com/1007-9327/13/5741.asp
Correspondence to: Professor Sandeep Nijhawan, Department of Gastroenterology,
Sms Medical College, Jaipur, India. dr_nijhawan@yahoo.com
Fax : +91-0141-2560994 Telephone: +91-0141-2722335
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by The WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology