Abstract
The patient was a 57-year-old man who was admitted to our hospital with a complaint of severe epigastric pain. Ultrasonographic examination revealed that the gallbladder was filled with a sludge like substance mixed with low and high echogenecity. On computed tomography the gallbladder wall was enhanced by contrast material. At the time of performing ERCP we found the blood outflow from Vater's papilla. The contrast material's inflow to the gallbladder was poor and unequal on the cholangiographic exami-nation. Though the gallbladder wall showed a flat shadow defect partially, the angiogra-phy detected no definite abnormal finding. According to these findings, we suspected the hemobilia associated with cholecystitis. But as malignant tumor could not be ruled out, we performed cholecystectomy. Histologically, the gallbladder wall revealed so-called "Adenomyomatosis" ac-companied by gallstones and chronic cholecystitis. There was an ulcer formation on the body, which was considered to be the origin of the hemobilia.
