Open AccessGastrointestinal Bleeding as the Initial Manifestation of a Polyarteritis Nodosa-Associated Hepatic Artery Aneurysm-Duodenal Fistula
Author(s) -
Thomas A. Shuster,
J. R. L. de Almeida,
Richard Coats,
Ajay Kalra,
Donald Silver
Publication year - 2004
Publication title -
vascular and endovascular surgery/vascular and endovascular surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.46
H-Index - 45
eISSN - 1938-9116
pISSN - 1538-5744
DOI - 10.1177/153857440403800611
Subject(s) - medicine , polyarteritis nodosa , aneurysm , vasculitis , gastrointestinal bleeding , fistula , artery , radiology , gastroenterology , surgery , disease
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.
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