A Benign Biliary Stricture Complicating Isolated Polyarteritis Nodosa

Lee, Woo Jin; Jang, Yoo Hyun; Kim, Yong Tae; Yoon, Yong Bum; Kim, Chung Yong; Kim, Sun Whe; Kim, Woo Ho

Abstract

Polyarteritis nodosa, a disease of the vasculitis of small- and medium-sized arteries, has diverse symptoms and signs. Gastrointestinal involvement is common, but localized involvement of the biliary tree or pancreas is very rare. We report a case of localized necrotizing arteritis involving the arteries around the pancreas and the common bile duct. The patient had jaundice by common bile duct stricture without any pancreatic pathology, and had no underlying abnormal laboratory findings which suggested systemic vasculitis. The arteritis was found incidentally in surgically resected specimens. To our knowledge, only a few cases of localized polyarteritis nodosa causing biliary tree stricture have been reported. It shoud be prudently judged through a long-term follow-up whether this lesion represents an early manifestation of a systemic vasculitis syndrome or a limited form of polyarteritis nodosa.