Cystic artery pseudoaneurysm secondary to acute cholecystitis: an unusual cause for haemobilia

Pseudoaneurysm of the cystic artery is a rarely described cause of haemobilia. We report the unusual presentation of upper gastrointestinal haemorrhage due to a pseudoaneurysm of the cystic artery secondary to acute cholecystitis that was complicated by gallbladder perforation and liver abscess in an 88-year-old male. The original CT scan had demonstrated a high density focus in the gallbladder neck that was thought to represent a calculus. Selective embolization of the cystic artery resulted in cessation of the haemorrhage. Owing to the patient’s frailty and comorbidities, he was not considered suitable for cholecystectomy. The case emphasizes the need for a high level of awareness of pseudoaneurysmal disease in association with inflammatory conditions.