title: Polyarteritis nodosa-induced pancreaticoduodenal artery aneurysmal rupture.
abstract: Polyarteritis nodosa (PAN) is a systemic, necrotizing vasculitis of small- and medium-sized arteries typically with multiorgan involvement. Most cases of PAN are idiopathic, although hepatitis B or C virus infections and hairy cell leukemia are important in the pathogenesis of some cases. PAN is characterized as segmental transmural inflammation of muscular arteries. Diagnosis is based on clinical suspicion, a negative immunofluorescence test for antineutrophil cytoplasmic antibodies, and whenever possible, biopsy conformation. Angiographic images may reveal microaneurysms affecting the renal, hepatic, or mesenteric vasculature. Aneurysmal formation and rupture are important complications that can be fatal. Treatment may warrant immunosuppression with steroids and cyclophosphamide. If left untreated, PAN can be fatal. To our knowledge, we report the second documented case of PAN-induced ruptured inferior pancreaticoduodenal artery aneurysm.
authors.affiliation: Division of Vascular Surgery, University of Minnesota Medical Center, Minneapolis, Minnesota.
authors.forename: Steven
authors.initials: S
authors.lastname: Levin
authors.affiliation: Division of Vascular Surgery, Abbott Northwestern Hospital, Minneapolis, Minnesota.
authors.forename: John
authors.initials: J
authors.lastname: Graber
authors.affiliation: Division of Vascular Surgery, Abbott Northwestern Hospital, Minneapolis, Minnesota.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ehrenwald
authors.affiliation: Division of Vascular Surgery, Abbott Northwestern Hospital, Minneapolis, Minnesota.
authors.forename: Nedaa
authors.initials: N
authors.lastname: Skeik
keywords: C-reactive protein; aneurysm; arteritis; coil embolization; mesenteric artery; vasculitis; vessel repair