Korean J Gastrointest Endosc.  2006 Jan;32(1):48-52.

A Case of Endoscopically Treated Jejunal Bleeding from Polyarteritis Nodosa

• Kwon HC
• Choi JW
• Choi SJ
• Woo SI
• Sun JS
• Won JH
• Suh CH
• Lee KM
• Hahm KB
• Kim JH

Abstract

Polyarteritis nodosa is a necrotizing vasculitis of the small and medium-sized arteries of multiple organ systems. The common symptoms of gastrointestinal involvement are abdominal pain, nausea, and vomiting. However, the symptoms at presentation are sometimes non-specific and vague. The well-known complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. We describe a case of a 6-year-old male with jejunal bleeding who was diagnosed with polyarteritis nodosa by angiography. After controlling the systemic symptoms with immunosuppressants and steroids, jejunal bleeding occurred. The jejunal bleeding was treated endoscopically with a hemoclip and increasing the immunosuppressant dose. Generally, massive gastrointestinal bleeding in a patient with polyarteritis nodosa is treated surgically. In this case, the jejunal bleeding was controlled with an endoscope because the bleeding site was located within reach of the endoscope, and systemic symptoms subsided with medication. There is no report of gastrointestinal bleeding from the polyarteritis nodosa in a child in Korea. Therefore, we report this case with a review of the relevant literature.

Keyword

Polyarteritis nodosa; Gastrointestinal hemorrhage; Jejunum

MeSH Terms

Abdominal Pain
Angiography
Arteries
Child
Cholecystitis
Endoscopes
Gastrointestinal Hemorrhage
Hemorrhage*
Hepatitis
Humans
Immunosuppressive Agents
Infarction
Jejunum
Korea
Male
Nausea
Polyarteritis Nodosa*
Steroids
Ulcer
Vasculitis
Vomiting
Immunosuppressive Agents
Steroids