Abstract
An 80-year-old man was transported to our hospital with melena and epigastralgia. Abdominal enhanced CT revealed findings suggestive of cholecystic hemorrhage. Laboratory tests revealed significant prolongation of the prothrombin time due to the warfarin that the patient was taking for deep venous thrombosis. Therefore, Vitamin K was administered first for neutralizing the warfarin. Then, a nasobiliary drainage tube was inserted endoscopically for relief of the cholestasis caused by the bleeding into the bile duct. Unfortunately, blood discharge from the nasobiliary drainage tube persisted, and the patient's anemia became worse. Therefore, on the following day, urgent laparoscopic cholecystectomy was performed. Cholecystic hemorrhage is comparatively rare, reportedly accounting for only about 1% of all cases of upper gastrointestinal bleeding. Because of the risk of complication by hemorrhagic shock, prompt diagnosis and treatment are needed. In this case, laparoscopic cholecystectomy was urgently performed for the cholecystic hemorrhage. In patients with stable hemodynamics, early laparoscopic cholecystectomy is a valid treatment modality for cholecystic hemorrhage, as this therapy is radical while being less invasive.
