Spontaneous rupture of hepatic artery aneurysm associated with polyarteritis nodosa. Am Surg 2010 Dec;76(12):1416-9
Date
01/27/2011Pubmed ID
21265359DOI
10.1177/000313481007601230Scopus ID
2-s2.0-78651376880 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
Polyarteritis nodosa (PAN) is a vasculitis, which often involves small and medium sized visceral arteries. This condition may result in multifocal aneurismal formation and end-organ damage. Uncommonly, PAN may present with rupture of hepatic artery aneurysms. Here, we report a rare case of a ruptured intrahepatic aneurysm associated with PAN. A 79-year-old woman presenting with abdominal pain had CT scan of the abdomen, which revealed hematoma in the right hepatic lobe. Visceral angiogram confirmed pseudo-aneurysm of a right hepatic arterial branch, and this was managed with endovascular coil embolization. The diagnosis of PAN was made and corticosteroid therapy was initiated. We also performed a literature review to define this condition's demographics, clinical presentations, and appropriate management. The review revealed 17 published cases of ruptured PAN-related intrahepatic aneurysms. We conclude that unexplained findings of visceral arterial aneurysms should prompt investigations for vasculitis as the etiology.
Author List
Parent BA, Cho SW, Buck DG, Nalesnik MA, Gamblin TCAuthor
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adrenal Cortex HormonesAged
Aneurysm, Ruptured
Female
Hepatic Artery
Humans
Polyarteritis Nodosa
Prednisone
Tomography, X-Ray Computed