BACKGROUND Hemorrhagic
cholecystitis is a
rare disease which can be fatal in some cases. Hemorrhagic
cholecystitis can sometimes be confused with common biliary diagnoses, as its symptoms imitate other
hepatobiliary diseases. We report a case of hemorrhagic
cholecystitis with
hemobilia caused by the administration of
anticoagulant agents. CASE REPORT A 70-year-old man was admitted with abdominal distention and
pain. Ultrasound (US) and computed tomography (CT) showed a distended and wall-thickened gallbladder with hyperdense materials. Based on these findings and the laboratory data, the patient was diagnosed with
acute cholecystitis with
cholangitis. Because the patient's hemodynamics were stable, endoscopic retrograde cholangiopancreatography (ERCP) was performed first to improve the bile flow. The results of ERCP showed blood from the common bile duct by cannulation, which was suspected to reflect hemorrhagic
cholecystitis. As the abdominal symptom and CT findings worsened on the day after ERCP, emergency
laparoscopic cholecystectomy was performed. An examination of the specimen revealed
ulcer formation on the mucosal side of the gallbladder. The patient was discharged 6 days after the operation without any surgical complications. CONCLUSIONS ERCP and early
laparoscopic cholecystectomy were performed for a patient with hemorrhagic
cholecystitis and
hemobilia. Early diagnosis and treatment can lead to good outcomes in patients with hemorrhagic
cholecystitis. Since the number of patients who are taking
antithrombotic agents is increasing, hemorrhagic
cholecystitis should be considered when any unusual imaging findings associated with
cholecystitis are observed.