Hemorrhagic cholecystitis causing hemobilia and common bile duct obstruction.

Biliary obstruction is a common problem associated with gallbladder pathology. However, hemorrhagic cholecystitis with hemobilia as the cause is quite rare. We present a case of hemorrhagic cholecystitis in the setting of systemic anticoagulation causing common bile duct obstruction which required endoscopic retrograde cholangiopancreatography (ERCP) for ductal clearance followed by laparoscopic cholecystectomy. The triad of right upper quadrant abdominal pain, jaundice and gastrointestinal bleed should prompt consideration of hemobilia in the setting of biliary obstruction.