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Case Reports
. 2017 Aug 17;11(2):488-493.
doi: 10.1159/000479497. eCollection 2017 May-Aug.

Hemorrhagic Cholecystitis in a Patient on Maintenance Dialysis

Masayuki Shishida  1 , Masahiro Ikeda  1 , Nozomi Karakuchi  1 , Kosuke Ono  1 , Naofumi Tsukiyama  1 , Manabu Shimomura  1 , Koichi Oishi  1 , Kazuaki Miyamoto  1 , Kazuhiro Toyota  1 , Seiji Sadamoto  1 , Tadateru Takahashi  1   2
Affiliations
Case Reports

Hemorrhagic Cholecystitis in a Patient on Maintenance Dialysis

Masayuki Shishida et al. Case Rep Gastroenterol. .

Abstract

The present paper describes a case of hemorrhagic cholecystitis in a patient on maintenance dialysis. The patient presented with right upper quadrant abdominal pain. Computed tomography revealed swelling of the gallbladder, high- and isodensity contents of the gallbladder, and high-density stone in the gallbladder neck. He was hospitalized for suspected acute cholecystitis. After hospitalization, his levels of total bilirubin, aspartate aminotransferase, and alanine aminotransferase increased. T2-weighted magnetic resonance imaging showed low-intensity contents expanded to include a wide area from the common bile duct to the cystic duct and gallbladder neck. Endoscopic retrograde cholangiopancreatography revealed clotting from the duodenal papilla. After cannulation of the bile duct, old blood and pus began to flow from the mammary papilla, and an endoscopic nasobiliary drainage tube was placed. After his liver function had improved, the patient underwent laparoscopic cholecystectomy. His sample revealed that the gallbladder was filled with blood clots and stones. His postoperative course was uneventful and he was discharged on day 19 after the procedure. Although hemorrhagic cholecystitis is rare, it should be considered as a differential diagnosis for patients on dialysis who have acute abdominal symptoms.

Keywords: Dialysis; Hemobilia; Hemorrhagic cholecystitis.

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Figures

Fig. 1.
Fig. 1.
Computed tomography and magnetic resonance cholangiopancreatography findings of hemobilia due to hemorrhagic cholecystitis. a On computed tomography, high- and isodensity contents of the gallbladder (arrow) were observed in a dialysis patient with hemorrhagic cholecystitis. b On magnetic resonance cholangiopancreatography, the common bile duct was not drawn.
Fig. 2.
Fig. 2.
Endoscopic retrograde cholangiopancreatography findings of hemobilia. a Clots and pus from the duodenal papilla. b Defect of the common bile duct.
Fig. 3.
Fig. 3.
Operative findings of hemorrhagic cholecystitis.
See this image and copyright information in PMC

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