Multiple hepatic artery aneurysms in a patient with systemic lupus erythematosus

Systemic vasculitis is a known complication of patients with systemic lupus erythematosus (SLE). Inflammation of the vessels can result in the development of arterial aneurysms with a potential risk of rupture or bleeding.

We present the case of a 56-year-old woman with SLE who developed three episodes of gastrointestinal (GI) bleeding without evidence of lesions in the GI tract. Multiple aneurysms of the hepatic artery were identified and treated with endovascular embolization, with no further GI bleeding. After embolization, the patient developed multiple bilomas that required percutaneous drainage, and subsequent abscesses which eventually resolved without further complications.

Hepatic aneurysms, possibly secondary to vasculitis, may cause GI bleeding, and should be suspected in patients with SLE and GI bleeding with no apparent cause identifiable through standard endoscopy of the upper and lower GI tract.