HEMORRHAGE into the gall bladder was first reported in 1892,1 but textbooks on surgery, medicine, and differential diagnosis do not list cholelithiasis and diseased gall bladders as a cause of blood in the stool. In 1946 Hudson and Johnson2 reported that 13% of 100 patients proved at operation to have cholelithiasis had varying amounts of blood in the stool preoperatively. A review of the literature to 1948 by Christopher and Savage3 revealed 28 cases of massive hemorrhage from the gall bladder exclusive of direct trauma.
All authors point out the significance of sclerotic changes in the wall of the gall bladder which by themselves or in combination with stones can produce bleeding that may manifest itself as melena, hematemesis, or rupture of the gall bladder.
A large stone in the neck of the gall bladder may erode the cystic artery, causing an exsanguinating hemorrhage first recognizable from
RIDGLEY FH. CHOLELITHIASIS CAUSING BLOOD IN THE STOOLSA Case of Massive Gastrointestinal Hemorrhage Due to a Gallstone. AMA Arch Surg. 1952;64(4):525-526. doi:10.1001/archsurg.1952.01260010541012