A Case of Severe Obstructive Jaundice due to Gallbladder Hemorrhage

Abstract

Gallbladder hemorrhage is a life-threatening condition that is rarely reported. A 69-year-old man was admitted to our hospital with abdominal pain and vomiting. Laboratory data showed an increase in inflammatory markers and deranged liver function test profiles, therefore indicating severe obstructive jaundice. Ultrasonography and computed tomography (CT) scans revealed the presence of blood clots in the gallbladder and common bile duct. The patient was diagnosed with gallbladder hemorrhage. Endoscopic retrograde cholangiopancreatography was performed, which revealed that the blood clot discharged through the Vater's papilla. The blood clot was successfully drained with endoscopic nasobiliary drainage. Cholecystectomy was performed, resulting in rapid improvements in the patient's clinical condition and liver function tests. Histopathological examination of the gallbladder showed necrotic cholecystitis. There have been 39 cases of gallbladder hemorrhage reported in Japan. Gallbladder hemorrhage can be fatal and requires urgent treatment. Good prognosis can be expected after cholecystectomy. We suggested that if the patient is medically fit for surgery, surgical intervention should be the primary treatment. In cases when drainage is required, endoscopic nasobiliary drainage is recommended.