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We present a case of primary renal artery aneurysm presenting as obscure overt upper gastrointestinal bleeding due to an arterioenteric and arteriovenous fistula in a HIV patient not on HAART. Despite the low incidence of visceral artery aneurysms, complications and clinical presentations demand rapid intervention to avoid high reported mortality rates. We highlight the diagnostic and treatment dilemmas of this fatal complication in an immunocompromised patient.

Obscure upper GIT haemorrhage: Primary renal artery aneurysm with duodenal and inferior venocaval fistulae