Acute Cholecystitis with a Hemocholecyst as an Unusual Presentation of Gallbladder Cancer: Report of a Case

Abstract

Several atypical presentations of gallbladder carcinoma have been reported, but one of the rarest is intraluminal hemorrhage. We report a case of carcinoma of the gallbladder disclosed by an emergency cholecystectomy, performed for acute cholecystitis caused by a hemocholecyst. The diagnostic approaches and characteristics of a hemocholecyst associated with carcinoma of the gallbladder are discussed.

Cholecystitis caused by hemocholecyst: An unusual complication of Hemophilia A

“…Indirect causes of hemocholecyst appear to come from the liver secondary to trauma. HC can cause hemobilia, and conversely, hemobilia may result in HC due to the reservoir function of the gallbladder [1][2][3][4]. We therefore believe that the term "HC" is appropriate in this case, since the blood clots were confined to the gallbladder even though they did not appear to have originated there.…”

“…CT scan can show hemorrhage while ultrasound reveals the presence of echogenic material within the gallbladder, as occurred with our patient. These findings suggest a differential diagnosis of gallstones, gallbladder carcinoma, polyps, sludge, or blood clot [1,3]. However, the sonographic demonstration of blood clots is quite variable and can be nonspecific.…”

“…Recent studies have documented that blood accumulation in the gallbladder is seen with iatrogenic trauma, anticoagulant therapy, lupus, liver biopsy, or ruptured aneurysms of either the hepatic or cystic artery [1][2][3][4] .…”

“…A hemocholecyst (HC) is a clot-filled gallbladder caused by bleeding within its lumen most commonly seen after trauma [1,2]. Distinguishing a HC from hemobilia may be difficult [1][2][3][4].…”

“…Distinguishing a HC from hemobilia may be difficult [1][2][3][4]. Hemophilia is a genetic bleeding disorder characterized by prolonged or spontaneous bleeding usually manifested as intra-particular and oral hemorrhages as well as bleeding into muscle, retroperitoneum and bowel wall [5].…”