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Nodular Polyarteritis With Superior Mesenteric Artery Involvement: A Report of a Complex Case
Yuling Ni1, Xiao Zhang1, Lei Lu1
1Department of Vascular Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, China.
British Journal of Hospital Medicine (London, England : 2005)
|October 24, 2025
Summary
Polyarteritis nodosa (PAN), an autoimmune vasculitis, can cause severe abdominal pain and bleeding due to intestinal artery aneurysms. Prompt diagnosis and combined embolization with immunosuppression offer effective treatment for this rare condition.
Area of Science:
- Vascular Medicine
- Autoimmune Diseases
- Gastroenterology
Background:
- Polyarteritis nodosa (PAN) is a systemic vasculitis affecting medium-sized arteries.
- PAN presents heterogeneously, often with complex gastrointestinal manifestations.
- Acute abdominal pain can be a critical presentation of PAN.
Purpose of the Study:
- To report a case of Polyarteritis nodosa presenting with acute abdominal pain.
- To illustrate the diagnostic and management challenges of PAN-related gastrointestinal hemorrhage.
- To highlight the effectiveness of a combined endovascular and immunosuppressive approach.
Main Methods:
- Case report of a 73-year-old male with acute abdominal pain.
- Diagnostic imaging included computed tomography angiography (CTA) and digital subtraction angiography (DSA).
- Interventional procedures involved arterial embolization; treatment included methylprednisolone therapy.
Main Results:
- CTA revealed a retroperitoneal hematoma and intestinal artery aneurysms.
- DSA confirmed PAN with superior mesenteric artery (SMA) aneurysms, stenoses, and dissections.
- Recurrent hemorrhage was controlled by embolization, and immunosuppression led to clinical improvement.
Conclusions:
- PAN should be considered in patients presenting with acute abdominal pain and vascular abnormalities.
- Staged endovascular embolization is crucial for managing acute hemorrhage.
- Immunosuppressive therapy is essential for long-term disease control in PAN.
