Haemorrhagic cholecystitis in a newly anticoagulated patient.
N J KinnearDerek Barry HennesseyRebecca ThomasPublished in: BMJ case reports (2017)
A 74-year-old man undergoing rehabilitation after pneumonia developed right upper quadrant abdominal pain. Five days earlier he had been commenced on apixaban for a new diagnosis of atrial fibrillation. Ultrasound and CT scans revealed an acalculous grossly thickened gallbladder, with high attenuation non-echogenic material both within and surrounding the structure. Active contrast extravasation was seen at the neck. On laparotomy, a perforated internally bleeding gallbladder containing a single calculus was found, with significant free blood within the abdomen. After cholecystectomy, the patient recovered slowly in hospital before nursing home placement.
Keyphrases
- atrial fibrillation
- abdominal pain
- computed tomography
- contrast enhanced
- case report
- magnetic resonance imaging
- healthcare
- magnetic resonance
- oral anticoagulants
- left atrial
- venous thromboembolism
- heart failure
- ultrasound guided
- catheter ablation
- direct oral anticoagulants
- single cell
- image quality
- emergency department
- acute coronary syndrome
- coronary artery disease
- adverse drug
- community acquired pneumonia