Abstract
A 59-year-old man presented with right upper quadrant pain and nausea. CT and ultrasonography showed hemorrhagic cholecystitis. In spite of conservative therapy due to his strong request, he was getting worse with severe pain and remarkable jaundice rapidly appeared and he needed an emergent operation in the next morning. In the operative findings, intra-abdominal hemorrhage was spouted out through the teared serosa of hepatoduodenal ligament. We found a perforation at the neck of GB which was the source of Bleeding. Furthermore, a large hematoma compressed the common hepatic duct. The bleeding disappeared after cholecystectomy. Intra-operative cholangiography didn't show any hematoma or stone in the choledochal duct. Histologically, it was diagnosed as hemorrhagic cholecystitis due to necrosis of whole layer with submucosal hemorrhage around perforated portion. There was no neoplastic lesion or abnormal vessel. Obstructive jaundice by outer compression to bile duct caused by hematoma in hemorrhagic cholecystitis with perforation was rare case.
