Massive intraperitoneal haemorrhage associated with transhepatic perforation of the gallbladder is very rare and occurs in association with acute cholecystitis in only one percent. In this case report, the authors present an unusual complication of acute cholecystitis, its diagnosis and surgical management.
Evaluation not only of clinical and laboratory findings but, above all, the addition of appropriate imaging is essential. Timing of the examination is crucial for correct preoperative diagnosis and to reduce the risk of urgent surgery.