1981 Volume 78 Issue 4 Pages 856-863
During 5 months form April to August in 1976, 20 cases of acute viral hepatitis mostly after abdominal or cardiovascular surgery were observed in Kanazawa Medical University Hospital. The incidence of postoperative hepatitis in this period was 2.21% for all operation and 13.7% for open abdominal or cardiovascular surgeries, which were 4 times higher than that in the other period. In 3 out of 20 cases, HBs-antigen was detected, and one case showed anti HA antibody of IgM type. Remained 16 cases was thought to be non-A, non-B hepatitis. Three out of 16 cases did not received blood trasfusion. Other virological studies have shown that cytomegalovirus, herpes simplex virus, and Epstein-Barr virus were not contributable to postoperative hepatitis in this study. From September of 1976 to March of 1978, 18 cases of postoperative hepatitis of non-A, non-B type were sporadically observed. The difference between two groups (epidemic and sporadic) was compared.
Incubation periods of the epidemic group were less than 4 weeks in 14 of 16 case, while the periods were longer than 5 weeks in 10 of 18 cases of the sporadic group. On the liver biopsy, all cases of the epidemic group revealed zonal or submassive necrosis, while 80% of the sporadic group showed spotty necrosis. Two cases of the epidemic group died with acute illness but none in the sporadic group. Serum transaminase levels and icters index were higher in the epidemic group than those of the sporadic group. About 40 to 50% of the cases took protracted course in both groups. Most cases of the epidemic group resolved within 1 to 2 years course. Finally, unresolved cases were 2 out of 12 cases in the epidemic group, and 5 out of 14 cases in the sporadic group. Clinical features of the epidemic group were short incubation period, severe acute illness and relatively good long-term prognosis. These results suggested a possibility that an outbreak of postoperative hepatitis was caused by a special type of virus.
Nippon Shokakibyo Gakkai Zasshi
Nippon Shokakibyo Gakkai Zasshi Kou
