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Medical Science Monitor Basic Research


An Intra-Operatively Diagnosed Case of Hemorrhagic Cholecystitis in a 43-year-old Patient: Case Report

Challenging differential diagnosis, Rare disease

George Khoury, Gregory Nicolas, Elias A. Abou-Jaoude, Nancy Emmanuel, Adnan Awdeh, Brian Bitar, Christian Saliba, Julien Sami Atef El Sayegh, Dani Osman, Elie Zaghrini

Lebanon Division of Surgery, Lebanese American University Medical Center, Beirut, Lebanon

Am J Case Rep 2019; 20:1732-1735

DOI: 10.12659/AJCR.915999

Available online: 2019-11-23

Published: 2019-11-23


BACKGROUND: Hemorrhagic cholecystitis is an uncommon occurrence in the setting of gallbladder pathology. It is a rare complication of acute cholecystitis that may have a misleading presentation and workup, making it challenging to diagnose pre-operatively.
CASE REPORT: We report the case of a 43-year-old female who presented for severe epigastric pain with nausea and vomiting and whose imaging was in favor of acute cholecystitis. The patient was scheduled for laparoscopic cholecystectomy, during which she was found to have hemorrhagic cholecystitis, later confirmed by pathology.
CONCLUSIONS: Hemorrhagic cholecystitis is an uncommon diagnosis in patients presenting with abdominal pain. The case discussed hereafter was found to have hemorrhagic cholecystitis intra-operatively. Urgent cholecystectomy is crucial in the setting of hemorrhagic cholecystitis due to its possible fatality. This case emphasizes the importance of thinking of hemorrhagic cholecystitis in a patient presenting for what appears to be a severe acute cholecystitis.

Keywords: Abdominal Pain, Cholecystectomy, Laparoscopic, Hemorrhagic Disorders