iarjsIARJSIARJS2789-6102https://doi.org/10.47310/iarjs.2023.v03i02.025Spontaneous Biloma Mimicking Hydatid Cyst Leading to Upper Gastrointestinal Bleed: A Case ReportPardeepKumarSharmaKapilNegiHarishDograAfshanAliThis case report describes a unique instance of a spontaneous biloma in a 68-year-old male patient with choledocholithiasis, presenting with acute cholangitis and an upper gastrointestinal bleed. Initially misdiagnosed as a hydatid cyst through abdominal ultrasonography, the patient's condition progressed to require emergency surgery following the development of gastrointestinal bleeding. The subsequent surgical exploration and contrast-enhanced CT scan identified the biloma, leading to a necessary sleeve gastrectomy. This case underscores the diagnostic challenge of spontaneous bilomas, particularly when presenting with atypical symptoms and emphasizes the importance of considering them in differential diagnoses for patients with biliary tract disorders and cystic abdominal lesions. This report aims to raise awareness about the critical need for accurate diagnosis in such complex cases, where misidentification can lead to delayed or inappropriate treatment.