Cholecystitis caused by hemocholecyst from underlying malignancy

Abstract

Massive hemobilia is a well recognized clinical entity, particularly when it presents with jaundice, GI bleeding, and biliary pain. However, occult hemobilia is more difficult to diagnose and has seldom been reported because of its clinically silent nature. In fact, this is usually overlooked until complications arise. Hemocholecyst or clot within the gallbladder may rarely occur in this setting, leading to cystic duct obstruction and cholecystitis. Most previous reports describe cholecystitis resulting from hemocholecyst after iatrogenic trauma. We describe two cases in which hemocholecyst occurred from underlying malignancies, both resulting in cholecystitis (acute or chronic).

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.…”

“…Despite the fibrinolytic nature of bile, a greater tendency to form a "pure" clot is seen with minor bleeding. These pure clots are more likely to lead to cystic duct obstruction and cholecystitis [2][3][4]. Direct causes of hemocholecyst are more limited and include malignancy, cholelithiasis, vascular disorders, and the presence of heterotopic gastrointestinal mucosa within the gallbladder.…”

“…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].…”