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\begin{document}

\title{Spontaneously perforation of gallbladder secondary to Hemorrhagic
cholecystitis}



\author[1]{sami Fendri}%
\author[2]{Haitham Rejab}%
\author[2]{Ayman Trigui}%
\author[2]{Bassem Abid}%
\author[2]{Youssef Mejdoub}%
\author[2]{salma ketata}%
\author[2]{Meriam Triki  TRIKI}%
\author[1]{Mohamed Ben Amar}%
\author[2]{Salah  Boujelbene}%
\affil[1]{Habib Bourguiba Hospital}%
\affil[2]{University of Sfax Faculty of Medecine of Sfax}%


\vspace{-1em}



  
  \date{May 25, 2024}


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\begin{abstract}
Hemorrhagic cholecystitis is a rare complication of acute cholecystitis.
Hemorrhage in the gallbladder can occur for a variety of reasons
(gallstone cholecystitis, secondary to trauma, percutaneous procedures,
neoplasms, bile parasites, or disorders of hemostasis).CT scan can help
the diagnosis. We report a case of hemorrhagic cholecystitis complicated
by gallbladder perforation%
\end{abstract}%



\sloppy


\textbf{Spontaneously perforation of gallbladder secondary to
Hemorrhagic cholecystitis}

\emph{Authors ~:} Sami Fendri, Haitham Rejab~, Ayman Trigui, Bassem
Abid~, Majdoub Youssef~, Salma Ketata\textsuperscript{1},Meriam
triki\textsuperscript{2}, Mohamed Ben Amar, Salah Boujelbene

Department of general and digestive surgery. Habib Bourguiba Hospital,
Sfax, Tunisia. 1 Department of anesthesia. Habib Bourguiba Hospital,
Sfax, Tunisia. 2 Department of pathology. Habib Bourguiba Hospital,
Sfax, Tunisia.

\emph{Corresponding Author~:}

Dr Sami Fendri

University of Sfax, Faculty of Medicine

Department of general and digestive surgery.

Habib Bourguiba Hospital, Sfax, Tunisia.

3029 Sfax, Tunisia

Phone number: (+216) 58121841. Fax: (+216) 74243427.

E-mail:\emph{sami.fendri@hotmail.com}

\emph{Patient's Consentment~:} Written informed consent was obtained
from the patient to publish this report in accordance with the journal's
patient consent policy.

\emph{Keywords:}

Hemorrhagic cholecystits, Perforation, surgery, pathology

\emph{Abstract:}

Hemorrhagic cholecystitis is a rare complication of acute cholecystitis.
Hemorrhage into the lumen of the gallbladder can occur for a variety of
reasons, including gallstone cholecystitis, secondary to trauma,
percutaneous procedures, neoplasms, bile parasites, or disorders of
hemostasis.

A CT scan can help with the diagnosis. We report a case of acute
hemorrhagic cholecystitis complicated by gallbladder perforation

\emph{Case presentation:}

We report the case of a 68-year-old male patient with no particular
history and who was admitted for management of pain in the right
hypochondrium evolving for 1 day without history of trauma.

The clinical examination found an abdominal pain on the right
hypochondrium. The biology revealed a high level of leucocytosis at
20,000 with a CRP at 143 without cholestasis or cytolysis.

Ultrasonography and abdominal CT showed an increased size, lithiasic
gallbladder with an 8mm thickened wall. In addition, there is a
spontaneously hyperdense content of the gallbladder with a low abundance
peritoneal effusion and a solution of continuity of the wall of the
gallbladder (Figure 1).

The patient was operated with a right subcostal laparotomy. The
exploration had shown a gallbladder with a thickened wall with a low
abundance hemoperitoneum. There was also a perforation of the body of
the gallbladder with a hematoma in its light, all suggesting a
perforation of acute hemorrhagic cholecystitis (Figure 2). A
cholecystectomy was performed (Figure 3) with passive drainage.

The postoperative course was simple.

\emph{Key clinical message:}Hemorrhagic cholecystitis is a rare
complication of acute cholecystitis. It is difficult to detect as its
symptoms are confused with other diagnoses. A computed tomography can
help diagnose. If it is not treated early, it can lead to death.

\emph{Fundings} : No Fundings needed for this publication

\emph{Aknowledgment} : Nothing to declare

\emph{Conflicts of interest:}

None declared

\emph{Ethic Statement:}

Personal data have been respected

\emph{Consent statement}

Written informed consent was obtained from the patient to publish this
report in accordance with the journal's patient consent policy

\emph{Authors' contribution:}

Sami Fendri : have operated the patientand write the manuscript ,
Haitham Rejab : have operated the patient and search bibliography, Ayman
Trigui : write the manuscript, Bassem Abid : write the manuscript,
Majdoub Youssef : search for the bibliography, Salma Ketata : search for
the bibliography, Meriam triki: done the pathology exam and revise the
manuscript, Mohamed Ben Amar: verify the manuscript before submission,
Salah Boujelbene : verify the manuscript before submission.

\emph{Data Availability Statement:}

Personal data of the patient were respected. No data is available for
this submission.

\emph{References:}

Jung-Nam Kwon. Hemorrhagic cholecystitis: report of a case. Korean J
Hepatobiliary Pancreat Surg 2012;16:120-122

Dong Keun Seok, Seung Seok Ki, Joon Ho Wang, Eon Soo Moon and Tae Ui
Lee. Hemorrhagic cholecystitis presenting as obstructive jaundice.
Korean J Intern Med 2013;28:384-385.
http://dx.doi.org/10.3904/kjim.2013.28.3.384

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