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Indian J Radiol Imaging. 2019 Jan-Mar;29(1):14-18. doi: 10.4103/ijri.IJRI_363_18.

"Honeycomb" pattern of gallbladder wall thickening - A forward step in early diagnosis of "Severe Dengue Fever".

Author information

Department of Radiology, Apollo Hospitals International Limited, Gandhinagar, India.
Department of Radiology, Institute of Neuroscience, Surat, India.
Department of Interventional Radiology, Dr. B. L. Kapur Hospital, New Delhi, India.
Department of Radiology, Dr. B. L. Kapur Hospital, New Delhi, India.


Aims and Objectives:

To study "Honeycomb" pattern of gallbladder wall thickening (GBWT) in dengue fever (DF) and to assess its clinical significance in early diagnosis of severe DF.

Materials and Methods:

A total 244 patients of DF were studied, 84 patients were classified as severe DF, 61 patients as DF with warning signs, and 99 patients as DF without warning signs. Abdominal ultrasound was performed for assessment of GBWT patterns, hepatomegaly, splenomegaly, pancreatic enlargement, ascites, pleural effusion, and other additional findings were recorded in severe DF cases. Statistical comparison between "Honeycomb" pattern of GBWT and clinically severe DF was done using Pearson correlation test.


Out of 244 patients, 145 patients were males and 99 patients were females, belonging to various age groups ranging from 1 to 81 years and 14.34% (35 patients) among them included in pediatric group. In total, 65.57% (160 patients) were non-severe DF cases and 34.42% (84 patients) were severe DF cases. A total of 84 patients of severe DF, 92.85% patients showed GBWT, and out of which, 71.42% patients had "Honeycomb" pattern, whereas a total of 160 patients of non-severe DF patients, 45% patients had GBWT and out of which, only 5.6% patients showed "Honeycomb" pattern. "Honeycomb" pattern of GBWT shows sensitivity of 71.4%, 94.37%, Positive predictive value of 86.95%, and Negative predictive value of 86.28% in severe DF.


"Honeycomb" pattern of GBWT is significant finding in severe DF. Its sensitivity and specificity are high in severe DF with significant statistical correlation. It can aid in early diagnosis of severe DF.


Dengue; gallbladder; gallbladder wall thickening; honeycomb pattern; severe dengue fever; ultrasound

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