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May 20, 1974

Hemocholecyst: An Angiographic Demonstration

Author Affiliations

From the Department of Diagnostic Roentgenology, Michael Reese Medical Center, Chicago.

JAMA. 1974;228(8):1026. doi:10.1001/jama.1974.03230330056024

HEMOBILIA is an uncommon cause of gastrointestinal bleeding, but one that is readily diagnosed by hepatic angiography. Of the 500 reported cases, bleeding originated from the gallbladder (hemocholecyst) in 13%, and usually resulted from erosion of the cystic artery in conjunction with cholelithiasis.1 Following is a report of hemocholecyst diagnosed preoperatively by angiography.

Report of a Case  A 64-year-old white man was first seen at Michael Reese Hospital and Medical Center with signs and symptoms suggesting diverticulitis of the colon. Roentgenograms identified a large, laminated calculus in the projection of the gallbladder and a reflex ileus pattern. On the 13th hospital day, an enema with barium sulfate (Fig 1) showed a paracolic mass on the right, which was found at laparotomy to be an infected hematoma. The patient did well and was discharged; his condition was diagnosed as retroperitoneal abscess caused by a perforated colonic diverticulum.The patient was