We report the case of an 85-year-old woman with a history of colitis who presented with pain in the right hypochondrium radiating to the back, vomiting and hematochezia.
The laboratory tests showed leukocytosis (14,300, neutrophils 84.5%), hemoglobin 7 g/dl, elevated C-reactive protein 179 mg/l, amylase 648 U/l, lipase 1,417 U/l and prescription pattern.
Abdominal computed tomography (CT) showed thickening of the gallbladder wall, cholelithiasis and an inflammatory process in the pancreatic tail.
Since the UGIB and anemia continued, an abdominal CT angiography was performed, visualizing a structure of lobulated contours within the gallbladder, hyperdense in the arterial phase, which did not change the cystic artery morphology.
The final diagnosis was acute pancreatitis secondary to hemobilia due to bleeding from cystic artery pseudoaneurysm.
Embolization was performed and the patient recovered.
