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Hemorrhagic Cholecystitis

Justin Parekh, MD; Carlos U. Corvera, MD
Arch Surg. 2010;145(2):202-204. doi:10.1001/archsurg.2009.265.
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Hemorrhagic cholecystitis is a rare cause of abdominal pain that can present in the setting of trauma, malignancy, and bleeding diathesis, such as renal failure, cirrhosis, and anticoagulation. Its symptoms are easily confused with acute calculous cholecystitis and might include hemobilia or hematemesis as blood drains from the gallbladder into the gastrointestinal tract. Imaging of hemorrhagic cholecystitis can be misleading unless the possibility of this diagnosis is considered. In this report, we present 2 cases of hemorrhagic cholecystitis along with relevant imaging and a review of the literature on this rare subject.

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Figure 1

Coronal T2-weighted magnetic resonance imaging of the upper abdomen. Arrow points to the filling defect in the distal common bile duct. Arrowhead points to an edematous gallbladder wall with enhancement and a uniform hypointense appearance (not consistent with stone density) within the gallbladder lumen.

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Figure 2

Intraoperative photograph demonstrating the highly inflamed, perforated, and gangrenous gallbladder (arrow).

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Figure 3

Photograph of opened gallbladder shows the V-shaped, long mucosal tear (arrow) and the removed intraluminal organized clot (arrowhead).

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