"The presenting features may mimic non-haemorrhagic acute cholecystitis, with right upper quadrant pain being a dominant feature. If the blood is passed through the biliary tree into the gut, haematemesis or passage of melaena may also occur, or blood oozing from the ampulla of Vater, known as haemobilia, may be seen at endoscopy 1. Blockage of the bile ducts by blood clots may cause biliary obstruction, with secondary painful jaundice and pain mimicking the passage of gallstones. There may be a reduction in the red blood cell count."