Ultrasound Assessment of Hepatobiliary and Splenic Changes in Patients With Dengue and Warning Signs During the Acute and Recovery Phases

Objectives To evaluate whether abdominal ultrasound (US) with a gallbladder (GB) contractility study or motor function test can be used as a diagnostic tool in patients with dengue and warning signs in acute and recovery phases. Methods Fifty‐one individuals in the acute phase of dengue presenting with warning signs (dengue group) and 49 healthy individuals without a history of dengue or hepatobiliary disease (control group) were studied with abdominal US and a GB contractility study. Results Statistical differences in US measurements of the liver (right lobe, P = .012; left lobe, P = .001) and spleen ( P = .008) dimensions, GB wall thickness ( P < .001), and the GB emptying fraction ( P < .001) were observed in dengue during the acute phase compared with the control group. After 60 days, abdominal US of the dengue group showed a statistical difference in liver (right lobe, P < .001; left lobe, P = .078) and spleen ( P < .001) dimensions, GB wall thickness, and the GB emptying fraction ( P < .001) compared with the results obtained during the acute phase. Furthermore, a statistical difference in the spleen volume and GB emptying fraction ( P < .001) was observed when comparing dengue after clinical recovery and the control group. Abdominal pain in patients with dengue was positively associated with hepatomegaly ( P = .031), splenomegaly ( P = .008), increased GB wall thickness ( P = .016), and a reduced GB emptying fraction ( P = .038) during the acute phase and with splenomegaly ( P = .001) and a reduced GB emptying fraction ( P = .003) after clinical recovery. Conclusions Abdominal US with a GB motor function test can be used as a diagnostic tool in patients with dengue during acute and recovery phases.