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Emergent laparoscopic surgical intervention for perforated hemorrhagic cholecystitis with hemodynamic instability

Baier, Alexander S
Liu, Dorothy
Yee, Jonson
Cherng, Nicole
Cui, Hongyi
Kim, Edward
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Alexander S Baier
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Document Type
Case Report
Publication Date
2022-10-19
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Abstract

Hemorrhagic cholecystitis is a rare diagnosis that closely mimics acute cholecystitis. Physical examination, laboratory studies and, in particular, computed tomography imaging allow for rapid diagnosis, stabilization and emergent surgical intervention. We describe our experience with three patients requiring emergent surgical intervention for hemorrhagic cholecystitis with unique clinical features including decreased platelet function due to liver cirrhosis, dual antiplatelet therapy and intraoperative finding of cholecystohepatic communication. Furthermore, we provide video recordings of two cases highlighting the severity of the disease. All presented patients were hemodynamically unstable and showed peritoneal signs on exam. Laboratory studies revealed moderate anemia and leukocytosis, while computed tomography suggested hemorrhage in the gallbladder. All patients required blood transfusions during their care and underwent laparoscopic cholecystectomy. Hemoperitoneum and gallbladder perforation were confirmed intraoperatively. Patients fully recovered without significant postoperative complications due to expedited operative management.

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Baier AS, Liu D, Yee J, Cherng N, Cui H, Kim E. Emergent laparoscopic surgical intervention for perforated hemorrhagic cholecystitis with hemodynamic instability. J Surg Case Rep. 2022 Oct 19;2022(10):rjac454. doi: 10.1093/jscr/rjac454. PMID: 36285168; PMCID: PMC9581507.

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DOI
10.1093/jscr/rjac454
PubMed ID
36285168
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© The Author(s) 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Attribution 4.0 International