Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report
Abstract Background Gallbladder hemorrhage is a rare but fatal condition. The reported causes of gallbladder hemorrhage include iatrogenesis, atherosclerotic changes in the cystic arteries, acute cholecystitis or cholelithiasis, malignancy, trauma, hemophilia, pseudoaneurysm, and the use of oral ant...
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Japan Surgical Society
2024-01-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-023-01799-1 |
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| author | Yuichi Hirose Yusuke Tajima Hiroki Sakata Toshimasa Uekusa Kentaro Kamada Takashi Ikehara Izuru Matsuda Satomi Yoneyama Akio Hidemura Hiroyuki Suzuki |
| author_facet | Yuichi Hirose Yusuke Tajima Hiroki Sakata Toshimasa Uekusa Kentaro Kamada Takashi Ikehara Izuru Matsuda Satomi Yoneyama Akio Hidemura Hiroyuki Suzuki |
| author_sort | Yuichi Hirose |
| collection | DOAJ |
| description | Abstract Background Gallbladder hemorrhage is a rare but fatal condition. The reported causes of gallbladder hemorrhage include iatrogenesis, atherosclerotic changes in the cystic arteries, acute cholecystitis or cholelithiasis, malignancy, trauma, hemophilia, pseudoaneurysm, and the use of oral anticoagulant medications. Recently, segmental arterial mediolysis (SAM) has been reported as a possible etiology of life-threatening abdominal, retroperitoneal, and intracranial hemorrhages. However, no previous reports have described the association between gallbladder hemorrhage and SAM. Case presentation A 59-year-old man was transferred to our hospital complaining of upper abdominal pain and vomiting. Contrast-enhanced computed tomography revealed high-density images of the gallbladder and common bile duct. However, there were no obvious findings of gallstones, cholecystitis, tumors, or aneurysms. He was diagnosed with gallbladder hemorrhage and bile duct obstruction. We performed a laparoscopic cholecystectomy after endoscopic biliary drainage. The gross appearance of the surgically resected specimen showed 12 small (3–12 mm), slightly elevated lesions on the gallbladder mucosa. Histologically, these slightly elevated lesions consisted of dilated muscular arteries of the gallbladder wall with fibrinoid degeneration of the media and focal loss of the internal and external elastic laminae. The histopathological diagnosis was confirmed as SAM. Conclusions To the best of our knowledge, this is the first reported case of a gallbladder hemorrhage associated with SAM. Our case report shows that SAM can cause gallbladder hemorrhage, suggesting that SAM should be considered in the differential diagnosis of gallbladder hemorrhage. |
| format | Article |
| id | doaj-art-0378236589044f4aa3eb258f5dcf2f3e |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-0378236589044f4aa3eb258f5dcf2f3e2025-08-20T03:32:33ZengJapan Surgical SocietySurgical Case Reports2198-77932024-01-011011710.1186/s40792-023-01799-1Gallbladder hemorrhage associated with segmental arterial mediolysis: a case reportYuichi Hirose0Yusuke Tajima1Hiroki Sakata2Toshimasa Uekusa3Kentaro Kamada4Takashi Ikehara5Izuru Matsuda6Satomi Yoneyama7Akio Hidemura8Hiroyuki Suzuki9Department of Surgery, Kanto Rosai HospitalDepartment of Surgery, Kanto Rosai HospitalDepartment of Surgery, Kanto Rosai HospitalDepartment of Pathology, Kanto Rosai HospitalDepartment of Gastrointestinal Medicine, Kanto Rosai HospitalDepartment of Gastrointestinal Medicine, Kanto Rosai HospitalDepartment of Radiology, Kanto Rosai HospitalDepartment of Surgery, Kanto Rosai HospitalDepartment of Surgery, Kanto Rosai HospitalDepartment of Surgery, Kanto Rosai HospitalAbstract Background Gallbladder hemorrhage is a rare but fatal condition. The reported causes of gallbladder hemorrhage include iatrogenesis, atherosclerotic changes in the cystic arteries, acute cholecystitis or cholelithiasis, malignancy, trauma, hemophilia, pseudoaneurysm, and the use of oral anticoagulant medications. Recently, segmental arterial mediolysis (SAM) has been reported as a possible etiology of life-threatening abdominal, retroperitoneal, and intracranial hemorrhages. However, no previous reports have described the association between gallbladder hemorrhage and SAM. Case presentation A 59-year-old man was transferred to our hospital complaining of upper abdominal pain and vomiting. Contrast-enhanced computed tomography revealed high-density images of the gallbladder and common bile duct. However, there were no obvious findings of gallstones, cholecystitis, tumors, or aneurysms. He was diagnosed with gallbladder hemorrhage and bile duct obstruction. We performed a laparoscopic cholecystectomy after endoscopic biliary drainage. The gross appearance of the surgically resected specimen showed 12 small (3–12 mm), slightly elevated lesions on the gallbladder mucosa. Histologically, these slightly elevated lesions consisted of dilated muscular arteries of the gallbladder wall with fibrinoid degeneration of the media and focal loss of the internal and external elastic laminae. The histopathological diagnosis was confirmed as SAM. Conclusions To the best of our knowledge, this is the first reported case of a gallbladder hemorrhage associated with SAM. Our case report shows that SAM can cause gallbladder hemorrhage, suggesting that SAM should be considered in the differential diagnosis of gallbladder hemorrhage.https://doi.org/10.1186/s40792-023-01799-1Gallbladder hemorrhageSegmental arterial mediolysisHistopathology |
| spellingShingle | Yuichi Hirose Yusuke Tajima Hiroki Sakata Toshimasa Uekusa Kentaro Kamada Takashi Ikehara Izuru Matsuda Satomi Yoneyama Akio Hidemura Hiroyuki Suzuki Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report Surgical Case Reports Gallbladder hemorrhage Segmental arterial mediolysis Histopathology |
| title | Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report |
| title_full | Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report |
| title_fullStr | Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report |
| title_full_unstemmed | Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report |
| title_short | Gallbladder hemorrhage associated with segmental arterial mediolysis: a case report |
| title_sort | gallbladder hemorrhage associated with segmental arterial mediolysis a case report |
| topic | Gallbladder hemorrhage Segmental arterial mediolysis Histopathology |
| url | https://doi.org/10.1186/s40792-023-01799-1 |
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