A patient with undifferentiated carcinoma of gallbladder presenting with hemobilia

Citation
H. Kubota et al., A patient with undifferentiated carcinoma of gallbladder presenting with hemobilia, J GASTRO, 35(1), 2000, pp. 63-68
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
JOURNAL OF GASTROENTEROLOGY
ISSN journal
0944-1174 → ACNP
Volume
35
Issue
1
Year of publication
2000
Pages
63 - 68
Database
ISI
SICI code
0944-1174(200001)35:1<63:APWUCO>2.0.ZU;2-8
Abstract
Hemobilia is relatively rare among hemorrhages in the digestive tract, and hemobilia caused by tumors of the biliary tract is particularly rare. We tr eated a 74-year-old-man with undifferentiated carcinoma of the gallbladder presenting with hl:mobilia. During hospitalization for neurogenic bladder a t the Department of Urology, he showed progressive anemia. Since hemorrhage in the digestive tract was suspected, endoscopy of the upper gastrointesti nal tract was performed, and bleeding from the papilla of Vater was observe d. On ultrasound examination, findings were indicative of cholecystic cance r, and hemorrhage from the cystic duct was found on percutaneous transhepat ic cholangioscopy. On perioral cholecystoscopy, however, masses of coagulat ed blood were found only in the gallbladder. Abnormalities such as dense st aining of tumors or extravasation were not found on angiography. The patien t died of hepatic failure due to rapid invasion of the liver by the tumor, associated with biliary infection and disseminated intravascular coagulatio n. At autopsy, a nodal tumor was found in the gallbladder, and the cavity o f the gallbladder was filled with coagulated masses of blood. Direct invasi on of the tumor to the liver, diaphragm, and transverse colon was found. Th e histopathological diagnosis was undifferentiated carcinoma (pleomorphic l arge-cell type).