Abstract
An 82-year-old man was admitted to our hospital for obstructive jaundice due to gallbladder and common bile duct stones. The common bile duct stones were successfully removed by endoscopic sphincterotomy (EST). Thereafter, he frequently suffered from gallstone attacks, and elective laparoscopic cholecystectomy was scheduled. However, he suddenly suffered from hematemesis, and underwent emergency endoscopy, which revealed a small amount of bleeding via the papilla of Vater. Subsequent CT and MRI revealed intraperitoneal bleeding. He underwent laparotomy, when a perforated gallbladder filled with blood and gallstones were found, which seemed to account for intraperitoneal bleeding. Intraoperative cholangioscopy showed no bleeding lesions in the bile duct. He underwent cholecystectomy and choledochoduodenostomy. Hemorrhagic cholecystitis with gastrointestinal and intraperitoneal bleeding is very rare. However, the possibility of hemorrhagic cholecystitis should be considered in patient with gallstone and concomitant intraperitoneal bleeding.
