Intraoperative left hepatic branch artery aneurysm rupture discovered during cholecystectomy: a case report of a rare and potentially lethal diagnosis

Hepatic artery aneurysm (HAA) is a rare but potentially lethal condition, accounting for ~20% of visceral aneurysms, with a reported rupture rate of up to 44%. Its pathophysiology remains incompletely understood, though risk factors include atherosclerosis, trauma, infection, connective tissue disorders, and iatrogenic causes. Clinical presentation varies from asymptomatic to abdominal pain, gastrointestinal symptoms, or biliary obstruction. Angiography-CT is the diagnostic modality of choice. Management is guided by symptoms, aneurysm size, and rupture status, ranging from observation to endovascular or surgical interventions. We report a case of hemoperitoneum due to a ruptured HAA that was incidentally discovered during a laparoscopic cholecystectomy.