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Hemorrhagic cholecystitis: the forgotten differential diagnosis
Noelia Espejo1, Solana Manceñido Buide2, Camila Juana2
1Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Medicina
|December 12, 2024
Summary
Hemorrhagic cholecystitis, a rare complication of acute cholecystitis, presents diagnostic challenges. Early diagnosis and surgical intervention are crucial for favorable outcomes in patients with upper gastrointestinal bleeding.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Hemorrhagic cholecystitis is an uncommon yet serious complication of acute cholecystitis.
- It presents diagnostic difficulties due to nonspecific symptoms and rarity.
Observation:
- A 59-year-old male with diabetes and obesity presented with abdominal pain and melena.
- Initial diagnostic workup was inconclusive, delaying diagnosis.
- A repeat contrast-enhanced CT scan revealed gallbladder collapse and intra-abdominal bleeding.
Findings:
- Exploratory laparoscopy confirmed a gangrenous, perforated gallbladder with active hemorrhage.
- The patient required intensive care but recovered fully postoperatively.
Implications:
- This case highlights the importance of considering hemorrhagic cholecystitis in patients with upper gastrointestinal bleeding.
- Contrast-enhanced CT scans are vital for diagnosis.
- Prompt surgical management is essential for successful treatment.
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