Many patients develop a mild leukocytosis. If associated with fever, bacteremia should be suspected. More commonly, WBC counts are decreased. Differential counts may show atypical cells and lymphocytosis. Abdominal radiographs have no role in evaluating acute viral hepatitis unless the physical examination suggests a perforated viscus.
Abdominal ultrasonography is recommended.
Rules out biliary obstruction in cases with significant nausea, vomiting, or fever. Liver biopsy is not usually necessary. Typical pathological findings are included in Histological Findings. The pathology picture is cholestatic, with stasis of canalicular bile and marked proliferation of intralobular bile ductules. The cholestasis is most notable within the centroacinar regions.