title: Haemorrhagic cholecystitis in a newly anticoagulated patient.
abstract: A 74-year-old man undergoing rehabilitation after pneumonia developed right upper quadrant abdominal pain. Five days earlier he had been commenced on apixaban for a new diagnosis of atrial fibrillation. Ultrasound and CT scans revealed an acalculous grossly thickened gallbladder, with high attenuation non-echogenic material both within and surrounding the structure. Active contrast extravasation was seen at the neck. On laparotomy, a perforated internally bleeding gallbladder containing a single calculus was found, with significant free blood within the abdomen. After cholecystectomy, the patient recovered slowly in hospital before nursing home placement.
authors.affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia ned.kinnear@gmail.com.|Department of General Surgery, Lyell McEwin Hospital, Elizabeth Vale, Australia.
authors.forename: Ned
authors.identifier: http://orcid.org/0000-0002-7833-2537
authors.initials: N
authors.lastname: Kinnear
authors.affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia.|Department of Urology, Craigavon Area Hospital, Portadown, UK.
authors.forename: Derek Barry
authors.initials: DB
authors.lastname: Hennessey
authors.affiliation: Department of General Surgery, Lyell McEwin Hospital, Elizabeth Vale, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Thomas
mesh_terms: D000368:Aged; D002764:Cholecystitis / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D011720:Pyrazoles / Q000008:administration & dosage* / Q000009:adverse effects; D011728:Pyridones / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban
keywords: Drugs and medicines; Gastrointestinal surgery; Haematology; Surgery