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Gangrene of Gallbladder with Shock from Intraperitoneal Hemorrhage

ARNE E. SCHAIRER, M.D.; JOHN L. KEELEY, M.D.
AMA Arch Surg. 1958;76(6):1000-1003. doi:10.1001/archsurg.1958.01280240158027.
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Recent reports1,2 have emphasized the rare occurrence of gross intraperitoneal hemorrhage with gangrene of the gallbladder. We wish to report an instance of this kind and to summarize certain aspects of this entity on the basis of a study of all available reports of this condition.

Report of Case  A 54-year-old housewife was admitted to the hospital at midnight because of severe abdominal pain localized to the right upper quadrant, of 48 hours' duration. The patient had been given two injections of morphine while at home. Attacks of right upper quadrant pain had occurred at intervals during the preceding five years.The oral temperature was 97.6 F (36.4 C); the pulse rate was 96 per minute; respirations were 22 per minute, and the blood pressure was 110/80 mm. Hg. Abdominal tenderness and rigidity were severe in the right upper quadrant, and 100 mg. of meperidine (Demerol) hydrochloride was given

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