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Case Report
Cholecystitis causing rupture of the cystic artery and massive hemoperitoneum
1 Department of Surgery, Westmead Hospital, Westmead, NSW, Australia
2 Department of Surgery, Port Macquarie Base Hospital, Port Macquarie, NSW, Australia
Address correspondence to:
Rowan Klein Nulend
Westmead Hospital, Cnr Hawkesbury Rd and Darcy Rd, Westmead, NSW 2145,
Australia
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Article ID: 100139Z12RN2024
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Klein Nulend R, Tse A, Pollitt T. Cholecystitis causing rupture of the cystic artery and massive hemoperitoneum. J Case Rep Images Surg 2024;10(2):1–4.ABSTRACT
Introduction: Cholecystitis is a common surgical pathology; however, it is uncommonly associated with hemorrhage. Cases of hemoperitoneum secondary to cholecystitis are usually in the context of cystic artery pseudoaneurysms; however, no reports describe rupture of a non-aneurysmal cystic artery.
Case Report: We present a case of hemoperitoneum and hemorrhagic shock secondary to cholecystitis, with resultant rupture of a branch of the cystic artery, in the absence of a pseudoaneurysm. The patient was a middle-aged man who presented with severe right upper quadrant pain on a background of biliary colic. Imaging was consistent with cholecystitis, and significant volume free fluid in the right upper quadrant. The patient became shocked and was taken for laparoscopy, with conversion to laparotomy. 1.6 liters of hemoperitoneum was evacuated, and a cholecystectomy was performed. It appeared that a gallbladder perforation has caused rupture of a branch of the cystic artery, with resultant intraperitoneal hemorrhage. No pseudoaneurysm was identified. The patient made a complete recovery.
Conclusion: This was a previously unreported, yet life-threatening complication of cholecystitis. This report aims to present a novel case and promote awareness of this dangerous complication.
Keywords: Cholecystitis, Cystic artery rupture, Hemoperitoneum
SUPPORTING INFORMATION
Author Contributions
Rowan Klein Nulend - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Andrew Tse - Revising it critically for important intellectual content, Final approval of the version to be published
Timothy Pollitt - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Rowan Klein Nulend et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
