Hemorrhage into the biliary tract, commonly referred to as hemobilia, may produce a hemocholecyst, which may be manifested by abdominal pain, jaundice, and a distended gall bladder. As the case to be presented illustrates, a hemocholecyst associated with jaundice can conform with the clinical features of Courvoisier's law.
Intracholedochal hemorrhage, or a hemocholecyst, may develop after or in association with (1) trauma, inflammatory lesions, or neoplasms of the liver1; (2) trauma, neoplasm, intracholedochal intubation,2 or parasitic infestation of the extrahepatic bile ducts; (3) cholecystitis, cholelithiasis,3 hematoma,1 neoplasms,4 or apoplexy of the gall bladder5; (4) penetration or reflux hemorrhage from a duodenal ulcer6; (5) duodenal, ampullary, or pancreatic neoplasms, or (6) rupture of an aneurysm of the hepatic7 or cystic artery.8
The probable sequence of events in the following case of postnecrotic cirrhosis was thrombosis of the portal vein, aneurysmal dilatation of
BARZILAI R, KLECKNER MS. Hemocholecyst Following Ruptured Aneurysm of Portal VeinReport of a Case. AMA Arch Surg. 1956;72(4):725-727. doi:10.1001/archsurg.1956.01270220173023