Abstract
The patient was in her seventies with mixed connective tissue disease (MCTD) was being treated with corticosteroids and presented with hemorrhagic acalculous cholecystitis and hemobilia. Cholecystectomy was performed and pathological examination of the gallbladder wall revealed bleeding, stenosis of the small artery, and arterial vasculitis associated with MCTD.
Hemorrhagic acalculous cholecystitis is a rare but potentially fatal disease. The treatment of this disease in patients with collagen diseases, including MCTD and systemic lupus erythematosus, is controversial. Many reported cases have undergone cholecystectomy, or in other cases with conservative treatment with corticosteroids.
We recommend that patients with hemorrhagic cholecystitis undergo cholecystectomy if possible.
