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.
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.
Fundings : No Fundings needed for this publication
Aknowledgment : Nothing to declare