Systemic Necrotizing Vasculitis Presenting as Multiorgan Failure and Spontaneous Intra-abdominal Hemorrhage / 대한신장학회잡지

ABSTRACT

Ruptured aneurysms complicate the course of polyarteritis nodosa only infrequently. Most often they occur in renal or mesenteric vessels. We experienced a case of 48-year old woman with systemic necrotizing vasculitis who developed multiorgan failure and spontaneous intra-abdominal hemorrhage. Angiography showed diffuse narrowing and spontaneous hemorrhage of medium and small sized arteries in visceral and pelvic vasculature. So emergency embolization and removal of hematoma was done. About 3000cc of blood was collected in the abdominal cavity. There were fine small aneurysmal dilatations of arteries with multiple collaterals and they oozed spontaneously. Bleeding small vessels were ligated. Pathologic findings of the involved arteries showed severe inflammation and necrosis of vessel wall. She was treated with corticosteroid and cyclophsphamide for one year and achieved improvement in her clinical status.