Related Experiment Video
Updated: Aug 24, 2025
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Emergent laparoscopic surgical intervention for perforated hemorrhagic cholecystitis with hemodynamic instability
Alexander S Baier1, Dorothy Liu2, Jonson Yee2
1Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Insights
Hemorrhagic cholecystitis, a rare condition mimicking acute cholecystitis, requires prompt diagnosis via imaging and surgical intervention. This study details three unique cases, emphasizing rapid management for patient recovery.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Medical Imaging
Background:
- Hemorrhagic cholecystitis is an uncommon condition that presents similarly to acute cholecystitis.
- Early diagnosis and surgical intervention are crucial for managing this potentially life-threatening condition.
Observation:
- This report details three patients with hemorrhagic cholecystitis who presented with unique clinical features.
- These features included decreased platelet function from liver cirrhosis, dual antiplatelet therapy use, and intraoperative cholecystohepatic communication.
- All patients were hemodynamically unstable with peritoneal signs, moderate anemia, and leukocytosis.
Findings:
- Computed tomography imaging suggested gallbladder hemorrhage in all cases.
- Patients required blood transfusions and underwent laparoscopic cholecystectomy.
- Intraoperative findings confirmed hemoperitoneum and gallbladder perforation.
Implications:
- Expedited surgical management led to full recovery without significant postoperative complications.
- This case series highlights the importance of rapid diagnosis and intervention in hemorrhagic cholecystitis.
- Understanding unique clinical presentations aids in timely and effective treatment.
Abstract:
Hemorrhagic cholecystitis is a rare diagnosis that closely mimics acute cholecystitis. Physical examination, laboratory studies and, in particular, computed tomography imaging allow for rapid diagnosis, stabilization and emergent surgical intervention. We describe our experience with three patients requiring emergent surgical intervention for hemorrhagic cholecystitis with unique clinical features including decreased platelet function due to liver cirrhosis, dual antiplatelet therapy and intraoperative finding of cholecystohepatic communication. Furthermore, we provide video recordings of two cases highlighting the severity of the disease. All presented patients were hemodynamically unstable and showed peritoneal signs on exam. Laboratory studies revealed moderate anemia and leukocytosis, while computed tomography suggested hemorrhage in the gallbladder. All patients required blood transfusions during their care and underwent laparoscopic cholecystectomy. Hemoperitoneum and gallbladder perforation were confirmed intraoperatively. Patients fully recovered without significant postoperative complications due to expedited operative management.
