Document Detail


Spontaneous haemorrhagic perforation of gallbladder in acute cholecystitis as a complication of antiplatelet, immunosuppressant and corticosteroid therapy.
MedLine Citation:
PMID:  22778467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An older lady presented 1 week after being discharged from hospital with acute cholecystitis. She suffered a sudden onset lower abdominal pain and was in hypovolaemic shock upon arrival. It was noted that she had been on antiplatelet therapy after suffering a recent myocardial infarction, an immunosuppressor and steroids for rheumatoid arthritis. Her admission bloods revealed a platelet count of 83 with normal clotting factors. After resuscitation, a CT scan confirmed fluid in the abdomen possibly arising from the right subhepatic space. During laparotomy, bleeding was noted from a perforated and ischaemic-looking gallbladder, with an intact cystic artery and duct and no biliary calculi evident. The gallbladder was removed and the patient was transferred to intensive therapy unit. She recovered well within the subsequent 8 days and was discharged. Her histology described 'haemorrhage within the gallbladder wall along with oedema, fibrosis and patchy inflammation and no signs of malignancy or gangrene'.
Authors:
Ananth Vijendren; Kirsty Cattle; Marion Obichere
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-07-09
Journal Detail:
Title:  BMJ case reports     Volume:  2012     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2012  
Date Detail:
Created Date:  2012-07-10     Completed Date:  2014-01-07     Revised Date:  2014-07-09    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Cholecystectomy
Cholecystitis, Acute / chemically induced*,  diagnosis,  surgery
Female
Gallbladder / blood supply*,  drug effects,  surgery
Glucocorticoids / adverse effects*
Hematoma / chemically induced*,  diagnosis,  surgery
Humans
Immunosuppressive Agents / adverse effects*
Platelet Aggregation Inhibitors / adverse effects*
Rupture, Spontaneous
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Immunosuppressive Agents; 0/Platelet Aggregation Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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