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Gallbladder bleeding-related severe gastrointestinal bleeding and shock in a case with end-stage renal disease: A

Jun-Li Tsai1, Shang-Feng Tsai

  • 1Division of Family Medicine, Cheng Ching General Hospital Department of Internal Medicine, Division of Nephrology, Taichung Veterans General Hospital Department of Life Science, Tunghai University School of Medicine, China Medical University, Taichung Department of Medicine, National Yang Ming University, Taipei, Taiwan.

Medicine
|June 10, 2016
PubMed

Insights

Gallbladder rupture causing severe gastrointestinal bleeding is rare. This case highlights successful non-surgical treatment for gallbladder spillage-related bleeding, emphasizing rare causes of GI hemorrhage.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Radiology

Background:

  • Gallbladder (GB) bleeding is an infrequent clinical presentation, typically associated with cystic artery aneurysms or GB wall rupture.
  • Common signs of GB rupture include Murphy's sign and jaundice, with hemobilia being the usual manifestation of GB bleeding.

Observation:

  • This report details the first documented case of severe gastrointestinal bleeding stemming from gallbladder rupture-related bleeding.
  • Computed tomography revealed gallstone spillage, a contributing factor to the bleeding.
  • Uremic coagulopathy exacerbated the bleeding severity in this patient.

Findings:

  • Successful non-surgical management was achieved in a patient with gallbladder spillage-related rupture and bleeding, a novel therapeutic outcome.
  • The case underscores the importance of considering uncommon etiologies for significant gastrointestinal bleeding.

Implications:

  • Clinicians must maintain awareness of rare causes of gastrointestinal bleeding, including those originating from the gallbladder.
  • Prompt embolization of the identified bleeding artery is recommended as a primary intervention.

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