Hicks Natalie
Department of Urology, James Paget University Hosptial, Great Yarmouth, Norfolk, UK.
BMJ Case Rep. 2014 Jan 17;2014:bcr2013202437. doi: 10.1136/bcr-2013-202437.
Haemorrhagic cholecystitis is a rare cause of upper gastrointestinal bleeding and is a difficult diagnosis to make. This case report describes an orthopaedic patient, who developed deranged liver function tests and anaemia after a hemiarthroplasty of the hip. The patient had upper abdominal pain and black stools which clinically appeared to be melaena. An ultrasound scan of the abdomen was inconclusive, and therefore a CT was performed and the potential diagnosis of haemorrhagic cholecystitis was raised. An endoscopic evaluation of the upper gastrointestinal tract showed no evidence of other causes of upper gastrointestinal bleeding. Following an emergency laparotomy and cholecystectomy, she recovered well. This report aims to increase awareness about the uncommon condition of haemorrhagic cholecystitis, and to educate regarding clinical and radiological signs which lead to this diagnosis.
出血性胆囊炎是上消化道出血的罕见原因,且诊断困难。本病例报告描述了一名骨科患者,该患者在髋关节半关节置换术后出现肝功能检查异常和贫血。患者有上腹部疼痛和黑便,临床上看似是黑粪症。腹部超声检查结果不明确,因此进行了CT检查,进而提出了出血性胆囊炎的可能诊断。上消化道内镜评估未发现上消化道出血的其他原因。在急诊剖腹手术和胆囊切除术后,她恢复良好。本报告旨在提高对出血性胆囊炎这种罕见病症的认识,并就导致该诊断的临床和放射学体征进行教育。