Cystic Artery Pseudoaneurysm as a Complication of Acute Cholecystitis Presenting as Gastric Outlet Obstruction

Pseudoaneurysm of cystic artery is a rare complication of severe acute cholecystitis. We report an unusual complication of pseudoaneurysm of the cystic artery. A 42-year-old man with severe acute cholecystitis developed symptoms of gastric outlet obstruction, which was confirmed by upper endoscopy. Cross-sectional imaging showed a para duodenal hematoma because of ruptured cystic artery pseudoaneurysm. Selective angiogram confirmed the above findings, and the patient underwent therapeutic coil embolization of the pseudoaneurysm, with resolution of the symptoms of gastric outlet obstruction. An unexplained drop in hematocrit in the setting of severe cholecystitis should alert the clinician to the possibility of cystic artery pseudoaneurysm and its complications.