Hemorrhagic Cholecystitis With Cystic Artery Pseudoaneurysm Mimicking Gallbladder Cancer and Hepatic Metastases

Hemorrhagic cholecystitis is an uncommon but potentially life-threatening condition that can mimic malignancy on imaging studies.Cystic artery pseudoaneurysm is a rare associated finding that further complicates diagnosis.We report a case of a 78-year-old man presenting with right hypochondrial pain and fever.Initial imaging performed elsewhere was interpreted as gallbladder carcinoma with hepatic metastases.Repeat ultrasound, contrast-enhanced CT, and an MRI in our department demonstrated hemorrhagic cholecystitis, cystic artery pseudoaneurysm, and hepatic abscesses.Retrospective review of the prior CT confirmed that the pseudoaneurysm and hemorrhagic content had been misinterpreted as neoplastic.The patient underwent cholecystostomy and drainage of hepatic abscesses, with pathology excluding malignancy.This case highlights a rare presentation of hemorrhagic cholecystitis complicated by cystic artery pseudoaneurysm, mimicking gallbladder cancer.Careful multimodality imaging and correlation with clinical findings are essential to avoid diagnostic errors.