Hemorrhagic cholecystitis: about a case

Abstract

Introduction: Hemorrhagic cholecystitis is a very rare and high mortality disease. However, it may or may not be associated with gallstones. Hemorrhagic cholecystitis is difficult to diagnose, the inflammatory changes triggered by the hemorrhage, cause ulceration of the mucosa and necrosis, accompanied by a sustained inflammation where cytokines interact, provoking an exaggerated dilation of the gallbladder and finally its rupture, causing hemoperitoneum and even death. 

Objective: To describe a clinical case of a patient with hemorrhagic cholecystitis as a complication of acute cholecystitis. 

Material and methods: Retrospective descriptive study, presentation of a clinical case.  

Results: In this paper we show  the case of a 39 year-old, male patient is presented, who suffered an episode of severe abdominal pain associated with vomiting and jaundice; for which he required a medical evaluation with complementary tests and surgical procedures. An urgent laparoscopic cholecystectomy was performed to reveal a tense and necrotic gallbladder with multiple stones in its interior and a flattened mucosa, focally ulcerated while the rest of the tunic showed abundant bleeding. 

Conclusions: Hemorrhagic cholecystitis is an important and rare complication of acute cholecystitis, very difficult to diagnose preoperatively. However, the surgeon must know and handle it properly; since, when correlating: the clinic, the laboratory and the imaging methods, which are within reach; it will provide early surgical treatment and significantly decrease patient morbidity and mortality