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Related Experiment Videos

Hemobilia in systemic lupus erythematosus

A J Rhoton1, J H Gilliam, K R Geisinger

  • 1Department of Gastroenterology, Bowman Gray School of Medicine, Winston-Salem, NC.

Southern Medical Journal
|September 1, 1993
PubMed
Summary

A young woman with Systemic Lupus Erythematosus (SLE) developed acute cholecystitis. This case highlights hemobilia and bile duct obstruction as a new potential complication of active SLE.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Rheumatology

Background:

  • Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Gastrointestinal and hepatobiliary complications are known but less common in SLE patients.
  • Acute cholecystitis, particularly acalculous, is rarely reported as a direct complication of active SLE.

Observation:

  • A 22-year-old female with active SLE presented with symptoms suggestive of acute cholecystitis.
  • Diagnostic imaging, including abdominal ultrasonography and a biliary patency scan, revealed acalculous cholecystitis and common bile duct obstruction.
  • Surgical exploration confirmed acalculous cholecystitis and identified hemobilia.

Findings:

  • The patient experienced hemobilia, confirmed by intraoperative findings and liver biopsy.

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  • Acalculous cholecystitis and common bile duct obstruction were the primary intra-abdominal pathologies.
  • Surgical intervention successfully resolved the patient's acute symptoms.

    • Implications:

    • This case report suggests that hemobilia secondary to acalculous cholecystitis and common bile duct obstruction may represent a novel complication of active SLE.
    • Clinicians should consider SLE as a potential underlying factor in young patients presenting with unexplained hepatobiliary complications.
    • Further research is warranted to elucidate the pathogenic mechanisms linking SLE activity to these specific gastrointestinal manifestations.