Hemobilia from Ruptured Hepatic Artery Aneurysm in Polyarteritis Nodosa.
10.3904/kjim.2006.21.1.79
- Author:
Sung Soon PARK
1
;
Byeong Uk KIM
;
Hye Suk HAN
;
Ja Chung GOO
;
Joung Ho HAN
;
Il Hun BAE
;
Seon Mee PARK
Author Information
1. Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Chungbuk, Korea. smpark@chungbuk.ac.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't
- Keywords:
Hemobilia;
Polyarteritis nodosa
- MeSH:
Rupture/*complications;
Polyarteritis Nodosa/*physiopathology;
Male;
Humans;
Hepatic Artery/*pathology;
Hemobilia/diagnosis/*etiology;
*Embolization, Therapeutic;
Aneurysm, Ruptured/*complications/therapy;
Adult
- From:The Korean Journal of Internal Medicine
2006;21(1):79-82
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hemobilia, in patients with the diagnosis of polyarteritis nodosa, is rare at clinical presentation and has a grave prognosis. We describe a case of massive hemobilia, due to aneurysmal rupture, in a patient with polyarteritis nodosa. A 39-year-old man was admitted to the hospital with upper abdominal pain. The patient had a history of partial small bowel resection, for intestinal infarction, about 5 years prior to this presentation. Abdominal computed tomography demonstrated multiple high attenuation areas in the bile duct and gallbladder. Hemobilia with blood seepage was visualized on endoscopic retrograde cholangiopancreatography; this bleeding stopped spontaneously. The following day, the patient developed a massive gastrointestinal bleed with resultant hypovolemic shock. Emergent hepatic angiogram revealed multiple microaneurysms; a communication was identified between a branch of the left hepatic artery and the bile duct. Hepatic arterial embolization was successfully performed. The underlying disease, polyarteritis nodosa, was managed with prednisolone and cyclophosphamide.
