Document Detail

Spontaneous intra-hepatic haemorrhage in a patient with fever of unknown origin.
MedLine Citation:
PMID:  17664537     Owner:  NLM     Status:  MEDLINE    
Polyarteritis nodosa is a systemic necrotising vasculitis that affects the small- and medium-sized arteries. Multifocal aneurysmal formation in the renal, hepatic, and mesenteric vasculature is a hallmark of this condition, and spontaneous aneurysmal rupture may occur, resulting in life-threatening haemorrhage. We describe a 42-year-old man who initially presented with fever of unknown origin. A diagnosis could not be reached at that time despite extensive investigations. The fever subsided spontaneously after 8 weeks, and the patient remained well for 6 years until he was admitted again for evaluation of fever. During his hospital stay, he developed a spontaneous massive intra-hepatic haemorrhage resulting in hepatic rupture and a haemoperitoneum. The bleeding was controlled at emergency laparotomy. An abdominal angiography demonstrated multiple microaneurysms in the hepatic and mesenteric arterial vasculature. The clinical findings suggested polyarteritis nodosa, and the source of bleeding was probably a ruptured intra-hepatic artery aneurysm.
Vincent K S Leung; Clement Y W Lam; C C Chan; W L Ng; Tony K L Loke; I Sc Luk; T N Chau; Arthur H W Wu; W N Fong; S H Lam
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine     Volume:  13     ISSN:  1024-2708     ISO Abbreviation:  Hong Kong Med J     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-31     Completed Date:  2007-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512509     Medline TA:  Hong Kong Med J     Country:  China    
Other Details:
Languages:  eng     Pagination:  319-22     Citation Subset:  IM    
Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong.
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MeSH Terms
Aneurysm, Ruptured / complications*
Fever of Unknown Origin / etiology*
Hemorrhage / etiology*
Hepatic Artery*
Liver Diseases / etiology*
Polyarteritis Nodosa / complications*

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