Obstructive jaundice and melena caused by hemocholecyst: a case report

A hemocholecyst (HC) is a clot-filled gallbladder caused by bleeding into its lumen. Obstructive jaundice caused by the compression of HC to the hilar biliary tract is likely to be misdiagnosed as cholangiocarcinoma and is extremely rare. We herein report a case of obstructive jaundice and melena ca...

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Published inWorld journal of gastroenterology : WJG Vol. 19; no. 13; pp. 2126 - 2128
Main Authors Fan, Ying, Wu, Shuo-Dong, Kong, Jing
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 07.04.2013
Subjects
Abdomen - diagnostic imaging
Case Report
Cholangiocarcinoma - diagnosis
Diagnosis, Differential
Gallbladder Diseases - complications
Humans
Jaundice, Obstructive - etiology
Jaundice, Obstructive - surgery
Laparotomy
Male
Melena - etiology
Melena - surgery
Middle Aged
Thrombosis - complications
Tomography, X-Ray Computed
Ultrasonography
Biliary tract
Jaundice
Melena
Hemocholecyst
Obstruction
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Summary:A hemocholecyst (HC) is a clot-filled gallbladder caused by bleeding into its lumen. Obstructive jaundice caused by the compression of HC to the hilar biliary tract is likely to be misdiagnosed as cholangiocarcinoma and is extremely rare. We herein report a case of obstructive jaundice and melena caused by HC. A 57-year-old male patient presented with right upper quadrant pain associated with icteric sclera and melena was suspiciously diagnosed as having malignant cholangiocarcinmoa by abdominal ultrasonography, computed tomography and magnetic resonance imaging. Laparotomy found a hematoma in the gallbladder. The hematoma spread to the left hepatic lobe forming an exogenous mass which compressed the hilar biliary tract. Radical cholecystectomy and bile duct exploration with T-tube drainage were performed. Histopathological examination revealed massive necrosis of the gallbladder mucosa with inflammatory cells infiltration as well as intraluminal hematoma formation. One month after operation, a T-tube cholangiography revealed a normal biliary tree. We suggest that HC should be considered in patients with obstructive jaundice and melena after common causes are ruled out.
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Author contributions: Fan Y and Wu SD contributed equally to this work; Fan Y and Wu SD designed the research; Kong J discussed the clinical features of the patient and analyzed data; Fan Y, Wu SD and Kong J wrote the paper.
Correspondence to: Dr. Shuo-Dong Wu, the Second Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. surgeonfanying@yahoo.com.cn
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v19.i13.2126