Inflammation of the gallbladder without evidence of calculi is known as acute acalculous cholecystitis (AAC). AAC is frequently associated with gangrene, perforation, and empyema. Due to these associated complications, AAC can be associated with high morbidity and mortality. Medical or surgical treatments can be chosen according to the general condition of the patient, underlying disease and agent. Particularly in acute acalculous cholecystitis cases, early diagnosis and early medical treatment have a positive effect on the patient and protect them from surgical trauma. ACC is a rare complication of acute viral hepatitis A. Herein, we present an adult patient of acalculous cholecystitis due to acute viral hepatitis A. She responded to the conservative management. 1. Introduction Hepatitis A is generally an acute, self-limited infection of the liver by an enterically transmitted hepatitis A virus (HAV). Infection may be asymptomatic or result in acute hepatitis, and rarely, fulminant hepatitis can ensue. Recognized complications of hepatitis A include cholestasis, prolonged and relapsing disease, fulminant hepatitis, and triggering of chronic active autoimmune extrahepatic disease [1]. Acute acalculous cholecystitis (ACC) is a rare complication of acute viral hepatitis [2]. Although the origin is obscure, demonstrated invasion of the gallbladder and bile duct epithelium by HAV and cell-mediated immunologic response have been proposed in the pathogenesis of HAV infection induced cholecystitis [3, 4]. Herein, we report a case of acalculous cholecystitis due to acute viral hepatitis A along with the published literature. 2. Case Report A 31-year-old female patient was admitted to the hematology department because of pancytopenia in February 2013. She had nausea, loss of appetite, back and joint pain, darkening of urine, and abdominal pain for 10 days. Her medical history was unremarkable. There was no history of medication or drug abuse. Physical examination showed body temperature of 37.5°C, heart rate of 92/minute, and blood pressure of 110/60？mmHg. Scleral icterus was present. The right side of the abdomen was tender with painful fullness in the right hypochondrium (a positive Murphy’s sign). Her liver was painful and palpable 3？cm under right costal margin. After examination, she was referred to general surgery with a diagnosis of acute cholecystitis, and surgery was planned. Laboratory investigations revealed microcytic anemia, leukopenia, and thrombocytopenia, elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST),
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