2004 Volume 37 Issue 12 Pages 1857-1861
Hemorrhagic cholecystitis is rare. We report a case of it occurring during anticoagulant therapy. A stone incarcerated in the cystic duct made it difficult to diagnose hemorrhaging into the gallbladder and showed a fluid-fluid level in the gallbladder. The 69-year-old woman with upper abdominal pain, although anemia and liver dysfunction were detected at admission, abdominal ultrasonography showed only small stone in the gall-bladder. MRI and repeated abdominal ultrasonography showed a fluid-fluid level in the gallbladder, leading to the diagnosis of hemorrhagic cholecystitis with an incarcerated stone in the cystic duct necessitating chole-cystectomy. Only 6 cases of hemorrhagic cholecystitis during anticoagulant therapy have been reported in Japan. In our case, hemorrhage was suspected to have been caused by passing of a stone into the common bile duct. The prognosis of hemorrhagic cholecystitis is improving with progress in imaging diagnosis.
