A 76-year-old man on apixaban presented with abdominal pain, vomiting, and signs of haemorrhagic shock. Imaging showed a large volume haemoperitoneum with active arterial extravasation in the gallbladder fossa. The patient proceeded to emergency laparotomy, where a haemorrhage was thought to arise from within a perforated gallbladder. Cholecystectomy was performed, and haemostasis was achieved. Histology showed features of subacute on chronic cholecystitis, with some sections suggestive of underlying arteritis. Haemorrhagic cholecystitis is rare, and gallbladder perforation with massive intraperitoneal haemorrhage is still rarer. This article presents a case report and literature review of this entity.
Key words: haemorrhagic cholecystectomy, intraperitoneal haemorrhage, anticoagulation, laparotomy
|
