Acute pancreatitis as a rare extrahepatic manifestation of acute hepatitis a: a case report

Hepatitis A virus (HAV) infection remains one of the most frequent causes of acute viral hepatitis worldwide, particularly in developing countries where sanitation and hygiene are inadequate. The disease generally follows a benign and self-limiting course, characterized by fever, malaise, jaundice, and elevated liver enzymes. However, rare extrahepatic manifestations can occur, including renal, hematologic, neurologic, and pancreatic involvement. Among these, acute pancreatitis is an unusual but potentially serious complication that may alter the clinical course of hepatitis A infection. We report a case of a 23-year-old previously healthy male who presented with a five-day history of fever and malaise, followed by jaundice, dark urine, and severe epigastric pain radiating to the back, associated with recurrent vomiting. Laboratory findings revealed markedly elevated hepatic transaminases, bilirubin, and pancreatic enzyme levels. Serological testing confirmed acute HAV infection with positive HAV IgM, while tests for hepatitis B, hepatitis C, and HIV were negative. Abdominal ultrasonography demonstrated hepatomegaly with an enlarged, edematous pancreas and no gallstones or biliary obstruction. Contrast-enhanced computed tomography (CECT) confirmed acute interstitial pancreatitis without necrosis or pseudocyst formation. The patient was managed conservatively with intravenous fluids, proton-pump inhibitors, antiemetics, and analgesics. His symptoms improved gradually, and biochemical parameters normalized by day ten. He was discharged in stable condition and remained asymptomatic on follow-up. This case underscores acute pancreatitis as a rare but important extrahepatic manifestation of HAV infection. Early recognition and supportive therapy are crucial for complete recovery and prevention of complications. Acute pancreatitis is a rare but reversible extrahepatic complication of hepatitis A. Clinicians must maintain vigilance when patients with HAV infection complain of persistent epigastric pain. Early diagnosis through enzyme testing and imaging, followed by supportive management, ensures excellent outcomes and prevents unnecessary interventions or diagnostic delay.