Tavernaraki Kyriaki, Sykara Alexandra, Tavernaraki Ekaterini, Chondros Dimitrios, Lolis Evangelos D
CT-MRI Department, "Evaggelismos" General Hospital, Athens, Greece.
Abdom Imaging. 2011 Oct;36(5):565-8. doi: 10.1007/s00261-010-9672-y.
Hemorrhagic cholecystitis with subsequent gallbladder rupture and torrential bleeding is a very rare but life-threatening complication of acute biliary tract diseases. Its clinical presentation may be dubious and therefore Computed Tomography (CT) imaging plays a crucial role in a prompt and accurate diagnosis. We present a case of a 64 year-old male who was admitted to the emergency department with clinical findings of acute cholecystitis. During the following hours the patient became hemodynamically unstable and an emergency abdominal CT scan was performed. CT revealed massive hemoperitoneum containing free gallstones. In addition, active extravasation of iv contrast material inside the gallbladder lumen was demonstrated. Based on these findings hemorrhagic cholecystitis with gallbladder rupture was suspected and the patient underwent urgent laparotomy. We describe specific CT findings of this rare condition, thus emphasizing the role of imaging in facilitating urgent surgical treatment.
出血性胆囊炎继发胆囊破裂及大出血是急性胆道疾病中一种非常罕见但危及生命的并发症。其临床表现可能不明确，因此计算机断层扫描（CT）成像在快速准确的诊断中起着关键作用。我们报告一例64岁男性患者，因急性胆囊炎的临床表现入院急诊科。在接下来的几个小时里，患者血流动力学不稳定，遂进行了急诊腹部CT扫描。CT显示大量腹腔积血，内有游离结石。此外，还显示胆囊腔内有静脉造影剂的活动性外渗。基于这些发现，怀疑为出血性胆囊炎伴胆囊破裂，患者接受了紧急剖腹手术。我们描述了这种罕见病症的特定CT表现，从而强调了影像学在促进紧急手术治疗中的作用。
