RT Journal Article SR Electronic T1 Upper gastrointestinal blood cast due to massive oropharyngeal bleeding JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e251499 DO 10.1136/bcr-2022-251499 VO 15 IS 9 A1 Kartikeya Rajdev A1 Samih Khauli A1 Karim El-Kersh YR 2022 UL http://casereports.bmj.com/content/15/9/e251499.abstract AB We present a case of a patient with recurrent squamous cell cancer of the base of the tongue and right tonsil who developed severe haematemesis. An elongated blood cast of the upper gastrointestinal tract was noted in the emesis. The patient required emergent intubation and blood transfusions. A CT scan with contrast revealed the presence of a pseudoaneurysm of the right lingual artery. Successful control of bleeding was achieved with coil embolisation of the pseudoaneurysm and its feeding artery. This case highlights that oropharyngeal bleeding can mimic gastrointestinal bleeding.