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CASE REPORT
Haemorrhagic cholecystitis in a newly anticoagulated patient
  1. Ned Kinnear1,2⇑,
  2. Derek Barry Hennessey1,3,
  3. Rebecca Thomas2
  1. 1 Department of Urology, Austin Health, Heidelberg, Victoria, Australia
  2. 2 Department of General Surgery, Lyell McEwin Hospital, Elizabeth Vale, Australia
  3. 3 Department of Urology, Craigavon Area Hospital, Portadown, UK
  1. Correspondence to Dr Ned Kinnear, ned.kinnear{at}gmail.com

Summary

A 74-year-old man undergoing rehabilitation after pneumonia developed right upper quadrant abdominal pain. Five days earlier he had been commenced on apixaban for a new diagnosis of atrial fibrillation. Ultrasound and CT scans revealed an acalculous grossly thickened gallbladder, with high attenuation non-echogenic material both within and surrounding the structure. Active contrast extravasation was seen at the neck. On laparotomy, a perforated internally bleeding gallbladder containing a single calculus was found, with significant free blood within the abdomen. After cholecystectomy, the patient recovered slowly in hospital before nursing home placement.

  • Surgery
  • Gastrointestinal surgery
  • Haematology
  • Drugs and medicines

https://doi.org/10.1136/bcr-2016-214617

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    Footnotes

    • Contributors NK provided the initial concept and manuscript drafting. DBH and RT were responsible for manuscript review.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.