title: Hemorrhagic cholecystitis and hemobilia: two infrequent complications of systemic lupus erythematosus.
abstract: BACKGROUND
  the patients affected by systemic lupus erythematosus (SLE) often suffer gastrointestinal symptoms. The differential diagnosis should contemplate pathology of the gall bladder. We present the case of a patient with hemorrhagic lithiasic cholecystitis and hemobilia.
  
  
  METHODS
  24 year old female diagnosed with SLE under treatment with Sintrom®, Dacortin® and Dolquine® that presented acute lithiasic cholecystitis and hemobilia with a distal calculus. Cholecystectomy and aperture of the ductus choledochus were performed allowing to confirm the hemobilia and to extract the calculus.
  
  
  CONCLUSIONS
  The treatment of cholecystitis in the patients with SLE is controversial due to the fact that most reviewed cases have been solved with cholecystectomy, or in other cases with conservative treatment with corticosteroids. We believe that the presence of cholelithiasis in a patient with SLE with pain on the right hypochondrium and ultrasound confirming the suspicion of cholecystitis demands a surgical treatment since the cause may be vascular, lithiasic or combined. Besides, the possible complications will not respond to pharmaceutical treatment.
authors.affiliation: Department of General and Digestive Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. araleramsay@me.com
authors.forename: Rocío
authors.initials: R
authors.lastname: García Pérez
authors.forename: D
authors.initials: D
authors.lastname: Ruiz de Angulo
authors.forename: M J
authors.initials: MJ
authors.lastname: López Poveda
authors.forename: B
authors.initials: B
authors.lastname: Febrero Sánchez
authors.forename: D
authors.initials: D
authors.lastname: Navas Carrillo
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla Paricio
mesh_terms: D002764:Cholecystitis / Q000209:etiology*; D005260:Female; D006431:Hemobilia / Q000209:etiology*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D055815:Young Adult