An Intra-Operatively Diagnosed Case of Hemorrhagic Cholecystitis in a 43-year-old Patient: Case Report

The Clinical Significance of Hemorrhagic Cholecystitis

“…Rarely there is perforation with hemorrhage into the abdominal cavity. 5 Alternatively an impacted stone at the gall bladder neck causes an obstruction accompanied by inflammation and gall bladder distention, ultimately leading to necrosis or perforation of gall bladder. 3 …”

Hemorrhagic cholecystitis after coronary angiography

“…As stated earlier, the causes of the development of hemorrhagic cholecystitis may be biliary obstruction by gallstones, biliary malignancies, parasitic infections, coagulopathies and trauma [ 3 ]. Pathologically, it is described that it develops due to inflammatory changes that cause ulceration of the mucosa and of the gallbladder vessels, leading to gallbladder rupture and hemoperitoneum [ 6 ].…”

“…In CT scan the findings usually described are dense content with or without layering, which may mimic sludge [ 9 ], and if contrast was used, an extravasation of contrast to the lumen may be observed in the arterial phase [ 10 ]. Despite these tests, the specific diagnosis of hemorrhagic cholecystitis is sometimes difficult by the similarity with other gallbladder pathologies such as acute cholecystitis [ 3 ].…”

“…There are many causes of hemorrhagic cholecystitis. Among them we have the most frequent that is the biliary obstruction by gallstones that counts >50% of the cases [ 3 ]. Others less frequent are biliary malignancies, parasitic infections, coagulopathies and trauma [ 3 ].…”

“…The patient’s symptoms may also vary. Thus, in addition to abdominal pain and hemodynamic instability, patients may also present with hemoperitoneum due to gallbladder perforation or melena or hematemesis due to bleeding to biliary tract or obstruction of biliary tract due to clotted blood [ 3 ]. In the diagnosis an abdominal computed tomography (CT) has an important role as we will see later.…”