腹腔鏡下胆囊摘出術にて治療し得た抗凝固療法中の透析患者における胆囊内出血の1例

安藤 彰俊; 室野井 智博; 佐藤 瑞穂; 神戸 勝世; 上山 晋也; 松本 亮; 藏本 俊輔; 岡 和幸; 下条 芳秀; 木谷 昭彦; 比良 英司; 渡部 広明

doi:10.50840/jjacs.advpub_11-4

case-report

A case of intra-gallbladder hemorrhage treated laparoscopically in a dialysis patient receiving anticoagulant therapy

Akitoshi Ando, Tomohiro Muronoi, Mizuho Sato, Masato Kambe, Shinya Ueyama, Ryo Matsumoto, Shunsuke Kuramoto, Kazuyuki Oka, Yoshihide Shimojyo, Akihiko Kidani, Eiji Hira, Hiroaki Watanabe

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Keywords: hemodialysis, hemorrhagic cholecystitis, anticoagulant therapy

JOURNAL FREE ACCESS

2021 Volume 11 Issue 1 Pages 22-27

DOI https://doi.org/10.50840/jjacs.advpub_11-4

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Abstract

A 77-year-old man receiving anticoagulant therapy following aortic valve replacement for aortic regurgitation 2 months ago, developed persistent abdominal pain in the right upper quadrant after breakfast. Although vital signs were stable, the Murphy sign was positive, and plain abdominal computed tomography （CT） revealed a swollen gallbladder with high-density bile, suggestive of hemorrhage. Enhanced abdominal CT showed extravasation of the contrast medium in the gallbladder. An emergency laparoscopic cholecystectomy was performed based on the diagnosis of intra-gallbladder hemorrhage. No bleeding complications were noted, and he was discharged five days post-operatively. No pathological malignancy or aneurysm was found, and the patient was pathologically diagnosed with intra-gallbladder hemorrhage due to chronic cholecystitis. Although intra-gallbladder hemorrhage is relatively rare, proper diagnosis and treatment may improve the prognosis of patients.

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