Gallbladder perforation without cholecystitis in a patient awaiting liver transplantation: a peculiar case report of anaemia in cirrhosis

Marco Biolato,Giuseppe Marrone,Antonio Liguori,Antonio Grieco,Antonio Gasbarrini,Claudia Tarli,Brunella Barbaro

doi:10.1186/s12876-019-1018-9

Abstract

BackgroundAcute anaemia in decompensated liver cirrhosis is commonly caused due to gastrointestinal bleeding; however, sometimes, detecting the site of blood loss is challenging.Case summaryA patient on waitlist for orthotopic liver transplantation because of decompensated liver cirrhosis was admitted with acute anaemia and recurrence of ascites. Their abdomen CT showed migration of gallbladder stones in the pelvis while paracentesis documented hemoperitoneum. A diagnosis of gallbladder perforation was performed.ConclusionChallenging choice of a “wait and see” strategy with conservative therapy, avoiding high-risk cholecystectomy, resulted in a successful liver transplant.

Highlights

Acute anaemia in decompensated liver cirrhosis is commonly caused due to gastrointestinal bleeding; sometimes, detecting the site of blood loss is challenging
This study reports the case of a patient with advanced liver cirrhosis awaiting liver transplantation, who had presented with unexplained acute anaemia and received a final diagnosis of gallbladder perforation without cholecystitis, successfully treated by conservative treatment
This study reported a peculiar case of gallbladder perforation without cholecystitis in a cirrhotic patient awaiting liver transplantation

Summary

Introduction

Acute anaemia in decompensated liver cirrhosis is commonly caused due to gastrointestinal bleeding; sometimes, detecting the site of blood loss is challenging. Background In advanced liver cirrhosis, a haemorrhage is usually secondary to complications of portal hypertension, such as gastroesophageal variceal rupture, hypertensive gastropathy, gastric antral vascular ectasia or peptic ulcers [1, 2]. Gallbladder perforation occurs in 2–15% of acute cholecystitis cases with or without gallbladder stones while haemorrhagic cholecystitis and massive hemoperitoneum are very rare [3].

Results

Conclusion