Dengue-Induced Gastrohepatic Complications

Liver abnormalities are most common complications of dengue infection. Dengue-induced liver disease is manifested as hypochondrium pain, hepatomegaly, and jaundice. Major pathological changes include microvesicular steatosis and hepatocellular necrosis, Kupffer cell hyperplasia, Councilman bodies, and cellular infiltrates at portal tract. The liver injury in dengue generally varies from asymptomatic hepatic transaminase elevation to fatal acute liver failure (ALF). The incidence of ALF is more common among children as compared to adults. The management of dengue-induced liver injury revolves around meticulous fluid administration. Immediate resuscitation and exploratory laparotomy under platelet cover are to be performed to initiate primary surgical repair in case of gut perforation. This chapter describes the clinical manifestations, diagnosis, and management of GI involvements during the course of dengue viral infection (DVI).