Giant Gastroduodenal Artery Pseudoaneurysm due to Polyarteritis Nodosa as a Cause of Obstructive Jaundice: Imaging Findings and Coil Embolization Results

Excerpt

Polyarteritis nodosa (PAN) is a rare vasculitis that affects the small and medium artery walls focally and is characterized mainly by polymorphonuclear leukocyte infiltration and fibrinoid necrosis. The female-to-male ratio is 1/2.5. It is thought that immune complexes are active in the starting mechanism; however, the triggering antigen has not been found yet. Ischemic necrosis of the arterial wall, thrombosis of the lumen, aneurysm formation, and hemorrhage associated with aneurysm rupture might occur in the course of time, with progression of the inflammatory reaction. Multiple-system involvement is a well-known feature of the disease, and presentation varies with the system involved [1‐7]. The gastrointestinal system (GIS) involvement is seen in 50% of the cases and hepatic and jejunal arteries are affected frequently [1, 7]. Although the disease causes various hepatobiliary complications [2, 6], to our knowledge, obstructive jaundice as a complication of PAN has not been mentioned previously in the literature. In this report, imaging findings and endovascular therapy results of a patient who has intrahepatic hemorrhage, obstructive jaundice, and a giant gastroduodenal artery pseudoaneurysm are presented. …