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 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.
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Brodie A
BA
Parent
Sung W
SW
Cho
David G
DG
Buck
Michael A
MA
Nalesnik
T Clark
TC
Gamblin
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D011241:Prednisone