Abstract
An 86-year-old woman who had taken anticoagulant drugs for atrial fibrillation appeared to our hospital because of the onset of right upper abdominal pain while sleeping. Plain abdominal CT scan showed hematoma in the enlarged gallbladder. Abdominal enhanced CT scan demonstrated a strongly enhanced round-shaped lesion, 5 mm in diameter, located in the gallbladder and ruptured pseudoaneurysm was suspected. Emergency open cholecystectomy was performed with the diagnosis of gallbladder bleeding. Bloody ascites were observed around an enlarged gallbladder. The resected specimen of the gallbladder showed necrotic mucosa, but no exposed vessels were observed. Microscopic findings showed inflammatory cell infiltration and hemorrhage in all layers of the gallbladder. We etiologically considered that the anti-coagulation therapy might promote the bleeding from the gallbladder which had been prone to blood due to inflammation. A further increase of gallbladder bleeding with anticoagulation therapy is estimated with an increase of the number of elderly people.
