Spontaneous rupture of hepatic artery aneurysm associated with polyarteritis nodosa

Am Surg. 2010 Dec;76(12):1416-9. doi: 10.1177/000313481007601230.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / etiology*
  • Female
  • Hepatic Artery* / diagnostic imaging
  • Humans
  • Polyarteritis Nodosa / complications*
  • Polyarteritis Nodosa / diagnosis
  • Polyarteritis Nodosa / drug therapy
  • Prednisone / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Adrenal Cortex Hormones
  • Prednisone