A Rare Case of Acute Pancreatitis in the Setting of Hemorrhagic Cholecystitis

Abstract

Hemorrhagic cholecystitis is a rare form of acute cholecystitis with very few cases reported in the literature. We report a novel case of a 79-year-old male who developed hemorrhagic cholecystitis and concomitant acute pancreatitis. The patient presented to the emergency department with a one-day history of severe epigastric pain radiating to his back. The patient was on an anticoagulant therapy for a history of pulmonary embolism. He had an elevated serum lipase and on a right upper quadrant ultrasound, a mildly distended gallbladder without stones was noted. Computed tomography (CT) the following day demonstrated heterogenous material in the gallbladder concerning for blood clots. Laparoscopic cholecystectomy with intraoperative cholangiogram (IOC) was performed that revealed a gallbladder filled with clots. He had an uneventful post-operative recovery.

Canine Gallbladder Erosion/Ulcer and Hemocholecyst: Clinicopathological Characteristics of 14 Cases

“…There are a few case reports and case series on human cases of hemorrhagic or necrotizing cholecystitis with hemocholecyst/hemobilia [19][20][21]. Possible etiological factors include iatrogenic causes, cholelithiasis, trauma, neoplasm, bleeding diathesis including anticoagulant medication, and vasculitides [20,21].…”

“…There are a few case reports and case series on human cases of hemorrhagic or necrotizing cholecystitis with hemocholecyst/hemobilia [19][20][21]. Possible etiological factors include iatrogenic causes, cholelithiasis, trauma, neoplasm, bleeding diathesis including anticoagulant medication, and vasculitides [20,21]. In addition, erosion or ulcers in human gallbladders have been described as a non-core histological finding in cases of acute/chronic calculous cholecystitis, immunoglobulin G4-associated cholecystitis, xanthogranulomatous cholecystitis, and ischemic gallbladder disease [22].…”