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Case Reports
. 2017 Apr 12:2017:bcr2016214617.
doi: 10.1136/bcr-2016-214617.

Haemorrhagic cholecystitis in a newly anticoagulated patient

Ned Kinnear  1   2 , Derek Barry Hennessey  3   4 , Rebecca Thomas  2
Affiliations
Case Reports

Haemorrhagic cholecystitis in a newly anticoagulated patient

Ned Kinnear et al. BMJ Case Rep. .

Abstract

A 74-year-old man undergoing rehabilitation after pneumonia developed right upper quadrant abdominal pain. Five days earlier he had been commenced on apixaban for a new diagnosis of atrial fibrillation. Ultrasound and CT scans revealed an acalculous grossly thickened gallbladder, with high attenuation non-echogenic material both within and surrounding the structure. Active contrast extravasation was seen at the neck. On laparotomy, a perforated internally bleeding gallbladder containing a single calculus was found, with significant free blood within the abdomen. After cholecystectomy, the patient recovered slowly in hospital before nursing home placement.

Keywords: Drugs and medicines; Gastrointestinal surgery; Haematology; Surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT abdomen, non-contrast, coronal slice through gallbladder neck, showing high attenuation, suggestive of fresh clot.
Figure 2
Figure 2
CT abdomen, venous phase post contrast, same coronal slice, showing new contrast trail inferiorly then laterally towards the gallbladder fundus, suggestive of active intra-luminal bleeding.
See this image and copyright information in PMC

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