title: Spontaneous liver haemorrhage and haemobilia as initial presentation of undiagnosed polyarteritis nodosa.
abstract: Polyarteritis nodosa (PAN) is a systemic necrotising vasculitis that could result in multifocal aneurysms of visceral arteries. Isolated multiple aneurysms of the hepatic arteries in the setting of PAN is extremely rare. Patients are typically asymptomatic and, very rarely, spontaneous  rupture with life threatening haemorrhage could be the initial presentation of an undiagnosed PAN. Accurate diagnosis, effective haemostasis and prompt initiation of immunosuppressive treatment with the help of a multidisciplinary team will improve the clinical outcomes.
authors.affiliation: Liver Unit, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK. docnaren@hotmail.com
authors.forename: N
authors.initials: N
authors.lastname: Battula
authors.forename: D
authors.initials: D
authors.lastname: Tsapralis
authors.forename: M
authors.initials: M
authors.lastname: Morgan
authors.forename: D
authors.initials: D
authors.lastname: Mirza
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging*; D005260:Female; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000209:etiology*; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D033162:Incidental Findings; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography