CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(01): 14-18
DOI: 10.4103/ijri.IJRI_363_18
Gastro-Intestinal Imaging

”Honeycomb” pattern of gallbladder wall thickening – A forward step in early diagnosis of “Severe Dengue Fever”

Jitendra Parmar
Department of Radiology, Apollo Hospitals International Limited, Gandhinagar
,
Maulik Vora
Department of Radiology, Institute of Neuroscience, Surat
,
Chander Mohan
Department of Interventional Radiology, New Delhi, India
,
Sandip Shah
Department of Radiology, Apollo Hospitals International Limited, Gandhinagar
,
Harsh Mahajan
Department of Radiology, Dr. B. L. Kapur Hospital, New Delhi, India
,
Tapan Patel
Department of Radiology, Apollo Hospitals International Limited, Gandhinagar
› Author Affiliations

Subject Editor: Financial support and sponsorship Nil.

Abstract

Aims and Objectives: To study “Honeycomb” pattern of gallbladder wall thickening (GBWT) in dengue fever (DF) and to assess its clinical significance in early diagnosis of severe DF. Materials and Methods: A total 244 patients of DF were studied, 84 patients were classified as severe DF, 61 patients as DF with warning signs, and 99 patients as DF without warning signs. Abdominal ultrasound was performed for assessment of GBWT patterns, hepatomegaly, splenomegaly, pancreatic enlargement, ascites, pleural effusion, and other additional findings were recorded in severe DF cases. Statistical comparison between “Honeycomb” pattern of GBWT and clinically severe DF was done using Pearson correlation test. Results: Out of 244 patients, 145 patients were males and 99 patients were females, belonging to various age groups ranging from 1 to 81 years and 14.34% (35 patients) among them included in pediatric group. In total, 65.57% (160 patients) were non-severe DF cases and 34.42% (84 patients) were severe DF cases. A total of 84 patients of severe DF, 92.85% patients showed GBWT, and out of which, 71.42% patients had “Honeycomb” pattern, whereas a total of 160 patients of non-severe DF patients, 45% patients had GBWT and out of which, only 5.6% patients showed “Honeycomb” pattern.”Honeycomb” pattern of GBWT shows sensitivity of 71.4%, 94.37%, Positive predictive value of 86.95%, and Negative predictive value of 86.28% in severe DF. Conclusion:”Honeycomb” pattern of GBWT is significant finding in severe DF. Its sensitivity and specificity are high in severe DF with significant statistical correlation. It can aid in early diagnosis of severe DF.



Publication History

Article published online:
23 July 2021

© 2019. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Hadinegoro S. The revised WHO dengue case classification: Does the system need to be modified?. Pediatr Int Child Health 2012; 32: 33-8
  • 2 World Health Organization. Working to overcome the global impact of neglected tropical diseases. First WHO report on neglected tropical diseases. Geneva, Switzerland: WHO; 2010
  • 3 Setiawan M, Samsi T, Pool T, Wulur H, Sugianto D, Pool T. Gallbladder wall thickening in dengue hemorrhagic fever: An ultrasonographic study. J Clin Ultrasound 1995; 23: 357-62
  • 4 Setiawan MW, Samsi TK, Wulur H, Sugianto D, Pool T. Dengue haemorrhagic fever: Ultrasound as an aid to predict the severity of the disease. Pediatr Radiol 1998; 28: 1-4
  • 5 Pothapregada S, Kullu P, Kamalakannan B, Thulasingam M. Is ultrasound a useful tool to predict severe dengue infection?. Indian J Pediatr 2016; 83: 500-4
  • 6 Oliveira G, Machado R, Horvat J, Gomes L, Guerra L, Vandesteen L. et al. Transient reticular gallbladder wall thickening in severe dengue fever: A reliable sign of plasma leakage. Pediatr Radiol 2010; 40: 720-4
  • 7 Sachar S, Goyal S, Sachar S. Role of ultrasound (”Honeycomb sign”) in early detection of dengue hemorrhagic fever. Arch Clin Exp Surg 2013; 2: 38-42
  • 8 WHO. 2009 Dengue: Guidelines for diagnosis, treatment, prevention and control. Available from: http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf
  • 9 Gubler D. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 1998; 11: 480-96
  • 10 Gopalakrishna S, Mohan K. Correlation of clinical, serological and radiological features of severe dengue fever. Sch J App MedSci 2015; 3: 1397-9
  • 11 Santhosh VR, Patil PG, Srinath MG, Kumar A, Jain A, Archana M. Sonography in the diagnosis and assessment of Dengue fever. J Clin Imaging Sci 2014; 4: 14
  • 12 Parmar JP, Mohan C, Vora M. Patterns of Gall Bladder Wall Thickening in Dengue Fever: A Mirror of the Severity of Disease. Ultrasound Int Open 2017; 3: E76-81
  • 13 Patriquin HB, DiPfietro M, Barber FE, Teele RL. Sonography of thickened gallbladder wall: Causes in children. AJR Am J Roentgenol 1983; 141: 57-60
  • 14 Shlaer WJ, Leopold GR, Scheible FW. Sonography of the thickened gallbladder wall: A nonspecific finding. AJR Am J Roentgenol 1981; 136: 337-9
  • 15 Wegener M, Börsch G, Schneider J, Wedmann B, Winter R, Zacharias J. Gallbladder wall thickening: A frequent finding in various nonbiliary disorders-a prospective ultrasonographic study. J Clin Ultrasound 1987; 15: 307-12