Abstract
A 68-year-old female with chronic renal failure and type 2 diabetes melitus presented unconscious. She was diagnosed as being uremic and recovered consciousness with hemodialysis. However, she vomited blood several times, and tarry stool was observed. On initial gastroendoscopy, no abnormalities were found. However, the hematemesis and melena continued. The third gastroendoscopy revealed blood spurting from the papilla of Vater ; a diagnosis of hemobilia was made. Enhanced abdominal CT showed an enlarged gallbladder (GB) and a high density area, 3 cm in diameter, located in the GB. A diagnosis of ruptured pseudoaneurysm of the cystic artery was made, and an open cholecystectomy was performed. On pathology, cholecystitis and a hematoma were diagnosed. GB hemorrhage is rare but should be considered in the differential diagnosis of patients with hematemesis and melena.
