Polyarteritis nodosa and acute abdomen: A role for laparoscopy?

Emanuele Asti; Luca Pogliani; Stefania Tritella; Luigi Bonavina

doi:10.1016/j.ijscr.2015.11.007

Polyarteritis nodosa and acute abdomen: A role for laparoscopy?

Int J Surg Case Rep. 2015:17:161-3. doi: 10.1016/j.ijscr.2015.11.007. Epub 2015 Dec 1.

Authors

Emanuele Asti¹, Luca Pogliani¹, Stefania Tritella², Luigi Bonavina³

Affiliations

¹ Department of General Surgery, University of Milan Medical School, IRCCS Policlinico San Donato, Italy.
² Department of Radiology, University of Milan Medical School, IRCCS Policlinico San Donato, Italy.
³ Department of General Surgery, University of Milan Medical School, IRCCS Policlinico San Donato, Italy. Electronic address: luigi.bonavina@unimi.it.

Abstract

Mesenteric vasculitis secondary to polyarteritis nodosa represents an atypical but potentially life-threatening cause of bowel ischemia and acute abdomen. The patient presented with severe abdominal pain of recent onset, pitting edema of the legs, renal failure and bowel wall thickening suggestive of mesenteric ischemia on CT scan. Early laparoscopy allowed to rule out proximal bowel necrosis and resection was avoided. The patient was successfully managed with corticosteroid therapy and repeated hemodialysis sessions.

Keywords: Acute abdomen; Laparoscopy; Mesenteric ischemia; Mesenteric vasculitis; Pitting edema; Polyarteritis nodosa.