title: Ruptured hepatic artery aneurysm: an unusual presentation of polyarteritis nodosa.
abstract: A 52-year-old woman presented with severe acute right upper quadrant abdominal pain and signs of intra-abdominal haemorrhage. CT and selective angiography revealed a ruptured right hepatic artery aneurysm and diffuse aneurysmatic disease involving most intra-abdominal organs, suggestive of polyarteritis nodosa. Although treatment with high-dose steroids was initiated, the patient died of progressive bowel ischaemia.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D A
authors.initials: DA
authors.lastname: Wicherts
authors.affiliation: Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: M M
authors.initials: MM
authors.lastname: Bruntink
authors.affiliation: Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Demirkiran
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: van Santvoort
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: K P
authors.initials: KP
authors.lastname: van Lienden
authors.affiliation: Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: C A
authors.initials: CA
authors.lastname: Ambarus
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: M G H
authors.initials: MG
authors.lastname: Besselink
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: van Gulik
mesh_terms: D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D011859:Radiography; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013256:Steroids
references.citation: J Vasc Surg. 2004 May;39(5):1122-4
references.pmid: 15111872
references.citation: Am Surg. 2010 Dec;76(12 ):1416-9
references.pmid: 21265359
references.citation: Ann R Coll Surg Engl. 2012 May;94(4):e163-5
references.pmid: 22613289
references.citation: Cardiovasc Intervent Radiol. 1993 Jul-Aug;16(4):254-6
references.pmid: 8104699