[Acute abdomen in a patient with polyarteritis nodosa: report of a case]

The authors present the case of a 31 year old woman admitted with abdominal pain, fever, weight loss and malignant hypertension. The ultrasonographic examination showed an image suggesting chronic nephropathy. On the 3rd day of hospitalization an exploratory laparotomy was performed with the diagnosis of acute abdomen. There was purulent peritonitis and a segment of ileum with multiple perforations, which was resected. The anatomopathologic finding of the surgical specimen revealed polyarteritis nodosa. The patient developed multiple organ failure and evolved to death. The difficulty in establishing the diagnosis is commented and, the authors according with some studies suggest treatment with plasmapheresis because the conventional therapy with methylprednisolone and cyclophosphamide proved to be insufficient in severe cases.