Spontaneous Rupture of Hepatic Artery Aneurysm Associated with Polyarteritis Nodosa

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 rupture...

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Bibliographic Details
Published in:The American surgeon 2010-12, Vol.76 (12), p.1416-1419
Main Authors: PARENT, Brodie A, CHO, Sung W, BUCK, David G, NALESNIK, Michael A, GAMBLIN, T. Clark
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Aged
Aneurysm, Ruptured - diagnostic imaging
Aneurysm, Ruptured - etiology
Biological and medical sciences
Female
General aspects
Heart failure
Hepatic Artery - diagnostic imaging
Humans
Hypothyroidism
Medical imaging
Medical sciences
Polyarteritis Nodosa - complications
Polyarteritis Nodosa - diagnosis
Polyarteritis Nodosa - drug therapy
Prednisone - therapeutic use
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Tomography, X-Ray Computed
Veins & arteries
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Summary: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.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481007601230