RESUMO
Polyarteritis nodosa is a necrotizing vasculitis which affects small and medium-sized arteries. The clinical features of the disease vary according to the site and extent of involvement. Aneurysmal dilatation and thrombosis in the arteries of the liver and gastrointestinal tract have been reported in polyarteritis nodosa. However, rupture of the hepatic aneurysm and necrotizing appendicitis due to polyarteritis nodosa are uncommon; indeed a case in which these have occurred together has not been reported to date. In this case report, a patient with necrotizing appendicitis and hepatic aneurysm rupture due to underlying poliarteritis nodasa is presented. Extensive intraabdominal hematoma and appendicitis were treated surgically and complete recovery was achieved.
Assuntos
Aneurisma Roto/diagnóstico , Apendicite/diagnóstico , Artéria Hepática , Poliarterite Nodosa/diagnóstico , Aneurisma Roto/cirurgia , Apendicectomia/métodos , Apendicite/patologia , Apendicite/cirurgia , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Poliarterite Nodosa/reabilitação , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia Doppler , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
A 75-year-old woman with polyarteritis who developed polyneuropathy and quadriplegia underwent intensive rehabilitation that resulted in significant improvement. This report discusses various therapeutic strategies for the successful management of patients with severe polyarteritis. Strategies include orthotics for both upper and lower extremities, sensory reeducation, edema management, and the use of adaptive devices in retraining the patient with activities of daily living. The associated neurological, orthopedic, renal, and cardiac complications in the context of rehabilitation for this complex condition are discussed.
