August 2012

Abnormal flow in the gallbladder

Clinical Info

Patient conservatively treated for a cholecystitis with acute onset of severe pain in the right upper abdomen

Ultrasound Images & Clips

Abnormal flow in the gallbladder

Gallbladder of the same patient a few weeks earlier
Gallbladder of the same patient a few weeks earlier
There are stones in the neck and the gallbladderwall is slightly thickened
There are stones in the neck and the gallbladderwall is slightly thickened
There is also some thickened bile in the gallbladder. The patient didn't want any invasive treatment and was therefore treated with antibiotics
There is also some thickened bile in the gallbladder. The patient didn't want any invasive treatment and was therefore treated with antibiotics
Gallbladder of the same patient a few weeks later. After an acute onset of severe abdominal pain. The gallbladderwall is thickened the lumen filled with echogenic material
Gallbladder of the same patient a few weeks later. After an acute onset of severe abdominal pain. The gallbladderwall is thickened the lumen filled with echogenic material
Another part of the gallbladder with echogenic contents
Another part of the gallbladder with echogenic contents
With color doppler there is a pulsatile jet into the gallbladder
With color doppler there is a pulsatile jet into the gallbladder
arterial flow in the gallbladder
arterial flow in the gallbladder
CT scan arterial phase there is contrast in the gallbladder lumen
CT scan late phase the amount of contrast in the gallbladder lumen has increased

Conclusion

Arterial hemorrhage in the gallbladder in a patient with a cholecystitis
Bleeding into the biliary tree or hemobilia is a rare cause for upper gastro-intestinal bleeding that was first described by Francis Glison in 1654. Most commonly hemobilia is the result of trauma or investigatory interventions but inflammation, vascular malformation, malignancy and coagulopathy were also described as potential causes of hemobilia.


Details

  • Sex: Male
  • Age: 87

Created with

  • Hitachi Ultrasound System