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KMID : 0385920070180040351
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Journal of the Korean Society of Emergency Medicine
2007 Volume.18 No. 4 p.351 ~ p.354
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A Case of Rupture of a Renal Artery Aneurysm in Polyarteritis Nodosa which is predicted early in Emergency Department
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Kim Sun-Pyo
Cho Soo-Hyung
Cho Nam-Soo
Byun Joo-Nam
Sun Kyeong-Hoon
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Abstract
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Polyarteritis nodosa (PAN) is a necrotizing angitis that predominantly affects small-and medium-sized arteries in
which microaneurysm or occlusion of the visceral arteries can be seen by arteriography. Patients with PAN may have
non-specific symptoms at the beginning of their illness, but progression can be sudden and result in severe, even life
threatening, complications. These include central nervous system hemorrhages, gastrointestinal hemorrhages or perforation, acute appendicitis, liver infarcts, acute renal failure, renal perirenal hematomas, and cardiac failure. A diagnosis of PAN should be considered when multiple small-sized aneurysms are detected by angiography, even if a biopsy is negative. Involvement of gastrointestinal and renal arteries is frequent in polyarteritis nodosa. The most common complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. Another rare but potentially life-threatening complication is perirenal hematoma caused by spontaneous rupture of renal aneurysm. Because of this possibility, rapid evaluation of these patients is necessary to make early diagnosis and
treatment possible. We describe an extremely rare case of polyarteritis nodosa with development of spontaneous
perirenal hematoma due to rupture of renal aneurysm, which was evaluated with immediate angiography and treated by coil embolization.
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KEYWORD
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Polyarteritis nodosa, Ruptured aneurysm, Hematoma
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