Achados ultra-sonográficos abdominais em pacientes com dengue

Abstract

OBJETIVO: Apresentar os achados ultra-sonográficos abdominais em pacientes com dengue e compará-los aos descritos na literatura. MATERIAIS E MÉTODOS: Foram realizados exames ultra-sonográficos abdominais de 38 pacientes, 25 do sexo feminino e 13 do sexo masculino, com idade média de 35 anos, com diagnóstico de dengue sorologicamente confirmado. Os achados foram comparados com os descritos na literatura. RESULTADOS: Os achados ultra-sonográficos mais relevantes foram espessamento difuso da parede da vesícula biliar em 18 casos (47,4%), líquido livre na cavidade abdominal e/ou pélvica em 12 (31,6%), esplenomegalia em 11 (28,9%), hepatomegalia em 10 (26,3%) e líquido pericolecístico em 10 (26,3%). Vinte e seis por cento dos pacientes apresentaram exames ultra-sonográficos normais. CONCLUSÃO: Os achados ultra-sonográficos abdominais são uma ferramenta adicional útil na confirmação de casos suspeitos de dengue hemorrágica e na detecção precoce da gravidade e da progressão da doença, sendo de extrema importância para o radiologista o conhecimento destes possíveis achados.

Dengue Hemorrhagic Fever in the State of Ceará, Brazil, 2005

“…do Vabo et al (2004) found among 38 patients submitted to abdominal ultrasound diffuse gallbladder wall thickening (47%), abdominal and/or pelvic free fluid in (31%), splenomegaly (29%), hepatomegaly (26%) and perivesicular fluid (26%). Khan et al (2008) detected ascites on abdominal ultrasound in two patients who fulfilled all the criteria for DHF.…”

Crianças necessitam de jejum antes de ultrassonografia abdominal?

“…Fasting has shown to be advantageous only in the evaluation of the gallbladder by the sonographer 2 ( p = 0.032), this advantage being not observed by the sonographer 1. phy in cases of abdominal emergency (15,16) . Such phenomenon contributes for an extension of the waiting time for the previously scheduled inpatients, considering that, usually, patients coming from the emergency department are examined at the intervals between previously scheduled studies.…”

Valor da ultrassonografia em crianças com suspeita de febre hemorrágica do dengue: revisão da literatura

“…Ultrasonography is a safe, low-cost imaging method that do not utilizes ionizing radiation, with high sensitivity to detect early signs of plasma leakage, many times in anticipation of the most critical period of the disease corresponding to the fever abatement to a temperature < 38°C, that is known as defervescence, where the risk for shock is higher. This critical phase extends from the third to the fifth day of febrile disease in children, where gallbladder wall thickening and cavitary effusion are ob-served in addition to severe abdominal pain, persistent emesis and increased hematocrit levels (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) .…”

“…Dengue fever is an arbovirosis responsible for annual epidemics in Brazil. It is caused by one of the four serotypes of dengue virus (DEN1, DEN2, DEN3 and DEN4), with a clinical spectrum ranging from asymptomatic to severe, life-threatening conditions (1)(2)(3)(4)(5) .…”

“…Symptomatic dengue virus infection presents as a nonspecific febrile condition, as classical dengue, dengue hemorrhagic fever (DHF) with capillary extravasation that may progress to shock, or dengue levels described as polyserositis (5,6) , classified into mild and severe, according to the World Health Organization criteria (1) .…”