A Case of Splenic Artery Pseudoaneurysm in HIV-TB Co-infection: Rare Cause of Haematemesis

Splenic Artery Pseudoaneurysm (SAP) is an uncommon false aneurysm that essentially develops due to the weakening of the vessel wall as a result of various local pathologies. Hereby, the authors present a case report, of a 32-year-old male with Human Immunodeficiency Virus (HIV) and Mycobacterium Tuberculosis (TB) co-infection presented with generalised weakness, vomiting, and a history of fever and cough. After admission, he developed massive haematemesis followed by hypotension; this led to an inconclusive upper gastrointestinal endoscopy. This prompted the authors to perform a contrast-enhanced Computed Tomography (CT) scan with angiography of the abdomen, which revealed an SAP, likely due to tubercular vasculitis. Embolisation of the pseudoaneurysm was performed using coils and N-Butyl Cyanoacrylate (NBCA) glue to stop the life-threatening haematemesis. The present case highlights the importance of considering SAP as a differential diagnosis in cases of unexplained haematemesis and emphasises the necessity of early embolisation as a life-saving measure due to its high fatality rate.