結節性多発動脈炎による腹腔内出血の1例

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  • A CASE OF INTRA-ABDOMINAL BLEEDING DUE TO POLYARTERITIS NODOSA

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A case of intra-abdominal bleeding due to polyarteritis nodosa (PN) is reported. A 73-year-old man was admitted to our hospital with feaver, muscle pain and general edema. Laboratory data indicated acute renal failure and the treatment was started. Immediately after that he developed abrupt abdominal pain and went into shock. Abdominal CT scan indicated an intra-abdominal bleeding and an emergency laparotomy was performed. The bleeding site was a branch of the iliocecal artery. Right hemicolectomy and ileostomy were conducted. Histological examination showed fibrinoid necrosis and destruction of the internal elastic lamina in medium-sized arteries, and the diagnosis was thus PN. Intra-abdominal bleeding due to PN is rare and only two cases have been reported in this country and eighteen cases in other countries to date. Further discussion is made by reviewing the related literature

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