Hemoperitoneum from Hemorrhagic Perforated Cholecystitis in a Patient with Acquired Deficiency of Factor VIII

Ardu, Massimiliano; Alemanno, Giovanni; Prosperi, Paolo; Tucci, Rosaria; Iacopini, Veronica; Frezzetti, Gianluca; Miele, Vittorio; Giordano, Alessio; Valeri, Andrea

doi:10.1177/000313482008600409

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…However, gallbladder hemorrhaging and rupture are extremely rare entities, with only a few previously reported cases, even in patients using anticoagulants or with bleeding disorders. According to reports, mechanical irritation of the gallbladder wall due to preceding repeated cholecystitis can result in hemorrhaging from the gallbladder and its rupture 4,5 . Yoshida et al reported on the outcomes with CTRX-associated pseudocholelithiasis.…”

Section: Discussionmentioning

confidence: 99%

Sudden-onset gallbladder rupture due to Ceftriaxone-associated pseudolithiasis in a patient with acquired hemophilia A

Harada

Shibano

Mukai

et al. 2022

Preprint

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We herein report a 76-year-old man with acquired hemophilia A (AHA) who developed gallbladder rupture due to Ceftriaxone (CTRX)-associated pseudolithiasis. The patient was admitted for an examination of systemic subcutaneous bleeding. A blood test showed a prolonged activated partial thromboplastin time and sequentially revealed low factor VIII activity (<1%) and a high factor VIII inhibitor level of 143 BU/mL. The patient was thus diagnosed with AHA. After admission, he developed a high-grade fever and was administered intravenous CTRX, considering the possibility of psoas abscess or cellulitis. Although his high-grade fever was improved, computed tomography incidentally showed a high-density lesion in the gallbladder, suggestive of CTRX-associated pseudolithiasis without clinical symptoms. Despite cessation of CTRX, the pseudolithiasis never disappeared, and the patient suddenly died after rapid progression of abdominal bloating. An autopsy revealed that the gallbladder was severely swollen and had ruptured with hemorrhaging because of hemorrhagic cholecystitis, caused by CTRX-associated pseudolithiasis with AHA. Our case demonstrated that CTRX-associated pseudocholelithiasis can unexpectedly induce gallbladder hemorrhaging and rupture in a patient with a bleeding diathesis, including AHA. CTRX-associated pseudocholelithiasis can cause a fatal outcome in patients with a bleeding disorder, even if CTRX is ceased as soon as pseudocholelithiasis is detected.

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Section: Discussionmentioning

confidence: 99%

Sudden-onset gallbladder rupture due to Ceftriaxone-associated pseudolithiasis in a patient with acquired hemophilia A

Harada

Shibano

Mukai

et al. 2022

Preprint

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“…1 Hemoperitoneum as a result of gallbladder perforation is even less prevalent, and has been reported in a limited amount of case reports. 2 Most of the reported cases occur in patients who are anticoagulated or have a bleeding disorder. 3 Treatment requires prompt operative intervention with broad spectrum antibiotics, often with the patient requiring an open operation.…”

Section: Hemoperitoneum From Acute Perforated Cholecystitsmentioning

confidence: 99%

“…Most cases that have described such scenarios as occurring in patients who had either been anticoagulated or had a bleeding disorder. 2 Laparotomy has also been employed in several of the case reports for successful management of the patient. 3 The patient was promptly sent to the ED by the physician who ordered the CT scan and the ED staff notified the surgeon on call in a timely fashion.…”

Section: Hemoperitoneum From Acute Perforated Cholecystitsmentioning

confidence: 99%

Hemoperitoneum from Acute Perforated Cholecystits

Chambers

2022

The American Surgeon

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“…Gallbladder perforation is seen in approximately 2–15% of cases of cholecystitis and carries a mortality rate of up to 42% 6. Gallbladder perforation secondary to haemorrhagic cholecystitis is very rare; we identified only 19 cases in the literature 2 4 6–22…”

Section: Introductionmentioning

confidence: 98%

Haemorrhagic cholecystitis in a young patient, complicated by gallbladder perforation and choledocholithiasis

Harrison,

Hepworth-Lloyd,

Briggs

et al. 2023

BMJ Case Rep

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Haemorrhagic cholecystitis is a rare condition associated with a high risk of morbidity and mortality. Its pathophysiology is thought to be due to gallbladder wall erosion and infarction secondary to inflammation, which subsequently leads to haemorrhage into the gallbladder lumen or the peritoneal cavity. There is no current official guidance on optimal management of this condition. We describe a case of a female patient in her 40s who presented with right upper quadrant pain, followed by haematemesis. After CT scan, a diagnosis of haemorrhagic cholecystitis was made and initially managed conservatively. In this case, haemorrhagic cholecystitis was later complicated by gallbladder perforation and choledocholithiasis. Definitive management was with emergency open cholecystectomy. We believe this to be the first reported case of haemorrhagic cholecystitis complicated by gallbladder perforation and choledocholithiasis. This report highlights the need for early definitive management of haemorrhagic cholecystitis to prevent subsequent complications.

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Hemoperitoneum from Hemorrhagic Perforated Cholecystitis in a Patient with Acquired Deficiency of Factor VIII

Cited by 4 publications

References 3 publications

Sudden-onset gallbladder rupture due to Ceftriaxone-associated pseudolithiasis in a patient with acquired hemophilia A

Sudden-onset gallbladder rupture due to Ceftriaxone-associated pseudolithiasis in a patient with acquired hemophilia A

Hemoperitoneum from Acute Perforated Cholecystits

Haemorrhagic cholecystitis in a young patient, complicated by gallbladder perforation and choledocholithiasis

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