A Rare Cause of Upper Gastrointestinal Tract Bleed: Ruptured Hepatic Artery Pseudoaneurysm

Upper gastrointestinal (GI) bleed is a difficult clinical situation to assess and manage.One rare cause of upper GI bleed is haemobilia, bleeding into the biliary tract due to any reason, such as trauma, previous hepatobiliary interventions, and aneurysms of the hepatic vasculature.The diagnosis can be difficult, especially when the patient presents with clinically worsening symptoms.Pseudoaneurysm of the hepatic artery bleeding into the biliary tract and causing GI bleed is a rare phenomenon and can be a challenging condition to diagnose and treat.This case report is about one such clinical presentation in which a pseudoaneurysm of the hepatic artery proper bled into the biliary tract, causing haemobilia and GI bleed.Associated ischaemia of the gallbladder was observed because the pseudoaneurysm was pressing upon the cystic artery.This led to biliary peritonitis secondary to perforation of the gallbladder.The patient presented with sepsis and an on/off GI bleed, making him anaemic.