CHOLECYSTIC hemorrhage presents in one or a combination of three clinical entities. According to Christopher and Savage,1 hemorrhage from the gallbladder can flow through the biliary ducts producing melena or hematemesis, remain confined in the gallbladder as a hemocholecyst, or produce sufficient pressure to rupture the viscus and result in hemoperitoneum. Surgical intervention offers the only reasonable treatment for any of these conditions, whether the situation presents as an acute abdomen or as a chronic recurrent gastrointestinal hemorrhage. Hemoperitoneum from rupture of the gallbladder is encountered only rarely in the course of laparotomy for an acute abdomen. The clinical picture may be that of an abdominal catastrophe requiring resuscitative therapy and urgent surgical intervention, or as a subacute illness over a period of several days. The following case of cholecystic apoplexy occurred in an acalculous gallbladder and produced rupture and hemoperitoneum.
Report of a Case
The patient, a 57-year-old