title: Jejunal obstruction as initial presentation of polyarteritis nodosa in a 13-month-old boy.
abstract: Systemic polyarteritis nodosa (PAN) is a rare disease in childhood affecting small and midsized arteries. The typical presentation in children is of isolated 1- or 2-organ involvement, and the diagnosis is often based on the histopathology. We report a case of pediatric PAN whose presenting symptom was jejunal obstruction owing to ischemic necrosis of the small bowel. The postoperative recovery was uneventful, and the patient responded well to steroid therapy. There are only a few cases of PAN with intestinal involvement described in the literature, some of them fatal. The diagnosis of PAN should be considered in children with acute intestinal obstruction with no obvious etiology, as early recognition and treatment may reduce its high mortality.
authors.affiliation: Paediatric Department, Paediatric Unit, University Hospital, 41124 Modena, Italy. andrea.venuta@unimore.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Venuta
authors.forename: Pier Luca
authors.initials: PL
authors.lastname: Ceccarelli
authors.forename: Diego
authors.initials: D
authors.lastname: Biondini
authors.forename: Federica
authors.initials: F
authors.lastname: Montanari
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000714:Anastomosis, Surgical; D018501:Antirheumatic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D007511:Ischemia / Q000150:complications*; D007579:Jejunal Diseases / Q000209:etiology* / Q000601:surgery; D007583:Jejunum / Q000098:blood supply* / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009336:Necrosis; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D014456:Ulcer / Q000209:etiology; D014839:Vomiting / Q000209:etiology
chemical_list: D018501:Antirheumatic Agents; D008775:Methylprednisolone