Hemobilia due to papillary adenoma of gallbladder: Imaging findings

Hemocholecyst is used to describe the presence of blood within gallbladder. It is usually caused by gallstones, cholecystitis, trauma and tumors of gallbladder. Hemocholecyst may be the only manifestation of occult hemobilia when a blood clot obstructs cystic duct leading to acute cholecystitis. We report a case of hemocholecyst and hemobilia due to papillary adenoma in a 25-year-old woman who presented with features of acute cholecystitis and jaundice. Endoscopic retrograde cholangiopancreatography revealed blood coming from papilla of Vater. Imaging with ultrasonography, magnetic resonance imaging and computed tomography demonstrated a pedunculated polypoid lesion arising from fundus of gallbladder that appeared to be the cause of hemobilia as suggested by its hypervascularity. Cholecystectomy was performed and a large bleeding polyp was seen arising from fundus of gallbladder which on histopathology proved to be papillary adenoma.