Ruptured mycotic hepatic artery aneurysm associated with methicillin sensitive staphylococcal endocarditis

Hemobilia is a rare cause of upper gastrointestinal hemorrhage. Classical presentations of hemobilia are biliary colic, jaundice, hematochezia and melena. Persistent bleeding sometimes requires urgent therapeutic intervention, such as angiographic intervention or surgery. It may be secondary to trauma, inflammatory disorders, gallstones or tumors. Hepatic artery aneurysm rupture is a rare cause of gastrointestinal bleeding. Mycotic hepatic artery aneurysm is not a common vascular lesion, but it is considered to be a late complication of bacterial endocarditis. We present a 43 years old man with history of bacterial endocarditis that led to aortic valve replacement (AVR) and mitral valve replacement (MVR) about 9 months ago, with present complaint of rectal bleeding and dizziness. Angiographic studies suggested ruptured mycotic aneurysm in right hepatic artery, which was successfully treated with coil embolization.