Gastrointestinal bleeding as the initial manifestation of a polyarteritis nodosa-associated hepatic artery aneurysm-duodenal fistula--a case report

Vasc Endovascular Surg. 2004 Nov-Dec;38(6):563-8. doi: 10.1177/153857440403800611.

Abstract

The authors report an unusual case of upper gastrointestinal bleeding from a hepatic artery aneurysm-duodenal fistula in a 21-year-old male. Arteriography revealed multiple visceral artery aneurysms. Biopsy of the hepatic artery aneurysm (HAA) revealed focal areas of necrosis, medial degeneration, fibrosis, and giant cells. The necrotizing vasculitis plus the multiple visceral aneurysms were highly suggestive of polyarteritis nodosa (PAN). This report reviews the pathophysiology and management of PAN and the diagnosis and management of HAA.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / diagnosis
  • Aneurysm / etiology*
  • Aneurysm / pathology
  • Aneurysm / surgery
  • Duodenal Diseases / diagnosis
  • Duodenal Diseases / etiology*
  • Gastrointestinal Hemorrhage / etiology*
  • Hepatic Artery* / pathology
  • Humans
  • Intestinal Fistula / diagnosis
  • Intestinal Fistula / etiology*
  • Male
  • Polyarteritis Nodosa / complications*
  • Polyarteritis Nodosa / physiopathology