Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review


Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review


Jerica Novak, MD, PhD, Aleksander Göntér, MD, Jurij Janež, MD, PhD

Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia, University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia.


Background: Hemorrhagic cholecystitis is an infrequent complication of acute cholecystitis associated with high mortality rate. Recognition of this acute abdominal condition is often challenging. Authors present a case of acute intraluminal gallbladder bleeding with a consequential gallbladder wall perforation and hematoperitoneum requiring emergency surgery in a patient on anticoagulant therapy.

Case Presentation: An 80-year old woman with atrial fibrillation on warfarin was presented to abdominal surgeon due to acute abdominal pain with hemodynamic instability and active intraluminal gallbladder bleeding on CT-scan. An emergency laparotomy with cholecystectomy was performed. Despite intensive treatment patient died on the third postoperative day.

Conclusions: Hemorrhagic cholecystitis is a potentially life-threatening condition. Patients on anticoagulant therapy with clinical signs of acute cholecystitis are more prone to develop bleeding into the gallbladder. Contrast-enhanced CT of the abdomen is the diagnostic modality of choice and cholecystectomy definitive therapy in patients with hemorrhagic cholecystitis.


Keywords: hemorrhagic cholecystitis, anticoagulant therapy, hematoperitoneum, abdominal CT, emergency surgery.


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How to cite this article:

Jerica Novak, Aleksander Göntér, Jurij Janež. Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review. International Journal of Case Reports, 2021; 5:228. DOI: 10.28933/ijcr-2021-06-2005


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