THE ACCURACY OF ULTRASOUND IN THE DETECTION OF HEPATITIS

1.1 INTRODUCTION
Patients presenting with hepatitis comprise the largest group of people reporting to medical and surgical out-patient department/OPDs. Following the history and clinical examination, ultrasonography has become one of the first and most useful methods of investigation1.
Hepatitis whether, acute or chronic, is caused by diseases of the liver, gall bladder, kidneys, pancreas, stomach, duodenum, spleen, pleura, pericardium and basal lung segments1,2. Rare causes include aortic aneurysm and acute myocardial infection. All these conditions have useful sonographic features which help in their diagnosis except uncomplicated peptic ulcer disease, acute myocardial infarction and based pnueumonitis1,2. The liver is the largest abdominal organ which weighs about 1.5kg and is located in the upper part of the abdomen predominantly on the right side. It has a complex structural organization which divides the lobules with enormous functional activities. All metabolic activities involve the liver and therefore the organ is the most frequently damaged organ in the whole body.
It is assumed that over five hundred separate activities occur within a single liver cell. These involve such broad categories as intermediary metabolism of carbohydrates, proteins and lipids. Synthesis of proteins such as fibrinogen, albumen, prothrombin and a host of enzymes, conjugation of bilirubin with glucuronide, detoxication and removal of foreign materials such as bacteria, drugs and other noxious substances, in addition to the above mentioned activities, storage of many substances such as proteins, glycogens, vitamins and minerals which including iron also takes place in the liver3.
All these enormous functional activities of the liver disposes of it to a number of pathological conditions which includes vascular disorders, metabolic, toxic, obstructive and neoplastic.
Different types of hepatitis exist under the major classifications: hepatitis A, and hepatitis B.
Hepatitis A includes those types that are caused by RNA virus which does not persist in the blood serum and can be transmitted by injection of infected food and water.
Hepatitis B is the type caused by DNA virus and it persist in the blood serum and can be transmitted by infected blood or by contaminated needles or others instruments.
It is important to emphasis that the functions of the liver may be impaired due to abnormality as a result of remarkable tolerance by the liver to inflamentation. It is well know that is is only when a greater part of the liver has being damaged that laboratory or x-ray show any abnormality4.
It then becomes necessary for ultrasound investigation. Ultrasound defects liver hepatitis weather A or B by demonstrating the stage at the time.
The researcher therefore wants to study and investigate how accurate ultrasound is in the defection of hepatitis. In a retrospective approach, he intends to determine how hepatitis are accurately detected by ultrasound in relation to provisional diagnosis and laboratory findings.