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Related Experiment Videos

Gallbladder bleeding associated with microscopic polyangiitis: a case report.

Daichi Kitaguchi1, Masanao Kurata1, Osamu Shimomura1

  • 1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan.

Journal of Surgical Case Reports
|August 31, 2017
PubMed
Summary
This summary is machine-generated.

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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

658
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
658

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Microscopic polyangiitis (MPA) can cause rare gallbladder bleeding, presenting as abdominal pain. Prompt surgical intervention, like laparoscopic cholecystectomy, is crucial for managing this serious condition.

Area of Science:

  • Vascular Medicine
  • Gastroenterology
  • Immunology

Background:

  • Microscopic polyangiitis (MPA) is a systemic autoimmune disease characterized by inflammation of small blood vessels.
  • ANCA-associated vasculitis (AAV) encompasses several conditions, including MPA, often affecting multiple organs.

Observation:

  • A 71-year-old male with a 6-year history of MPA presented with upper abdominal pain and nausea.
  • Contrast-enhanced CT revealed gallbladder bleeding, with conservative management leading to worsening anemia, hypotension, and tachycardia.

Findings:

  • Emergent laparoscopic cholecystectomy was performed due to the patient's deteriorating condition.
  • Intraoperative findings revealed a distended gallbladder with internal clots but no significant cholecystitis.
  • Histopathology confirmed perivascular inflammatory cell infiltration and vascular rupture as the cause of bleeding.

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Implications:

  • This case represents the first reported instance of gallbladder bleeding associated with MPA.
  • Gallbladder bleeding in MPA is a critical condition requiring prompt surgical management, as spontaneous hemostasis is unlikely.
  • Highlights the importance of considering vasculitis in unexplained gastrointestinal bleeding and the need for timely surgical intervention.