Hemorrhagic Cholecystitis Due to Rupture of Underlying Anomalous Duplicated Cystic Arteries

Hemorrhagic cholecystitis (HC) is a rare complication that can become rapidly fatal. Patients may present with hematemesis or melena, in addition to other common symptoms of acute cholecystitis. Delay in diagnosing HC postpones early intervention, and patients can quickly decompensate. We present a 33-year-old man with hematemesis and downtrending hemoglobin. Imaging revealed underlying anomalies of duplicate cystic arteries that ruptured, an occurrence never reported in the literature before. Bilateral cystic arteries were embolized successfully. This case demonstrates the importance of early consideration of HC as a differential. Recognition and timely diagnosis prompt urgent intervention, which can reduce morbidity.