Korean J Gastrointest Endosc > Volume 38(6); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;38(6): 364-367.
혈액담즙증으로 나타난 결절성 다발성 동맥염 1예
동국대학교 의과대학 내과학교실, *영상의학교실, 울산대학교 의과대학 내과학교실
A Case of Polyarteritis Nodosa That Presented as Hemobilia
Joo Wook Sung, M.D., Yun Jeong Lim, M.D., Jae Hyun Kwon, M.D.*, Kyung Jo Kim, M.D. and Jin Ho Lee, M.D.
Departments of Internal Medicine, *Radiology, Dongguk University College of Medicine, Goyang, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
Hemobilia is defined as hemorrhage into the biliary tract, and the patients with hemobilia present with abdominal pain, jaundice and gastrointestinal bleeding. The causes of hemobilia are traumatic or operative injury to the liver or bile ducts, intraductal rupture of the hepatic abscess or aneurysm of the hepatic artery. Cholecystitis can also develop in patients with hemobilia. Polyarteritis nodosa (PAN) is a multisystem, necrotizing vasculitis of the small and medium-sized muscular arteries and patients with this illness may present with fever, sweats, weight loss, severe arthralgia and myalgia. Mesentery artery involvement that can result in gastrointestinal hemorrhage, bowel infarction and perforation is rare, yet very serious in patients with PAN. We report here on a rare case of PAN that presented as hemobilia due to rupture of a hepatic arterial aneurysm. (Korean J Gastrointest Endosc 2009;38:364-367)
Key Words: Polyarteritis nodosa, Hemobilia, Gastrointestinal bleeding
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