Gastrointestinal Bleeding Secondary to Hepatic Artery Involvement of Microscopic Polyangiitis: Case Report and Review of the Literature

Spahn, Thomas W.; Ullerich, Hansjoerg; Lebitz, Pia; Wormanns, Dag; Gaubitz, M.; Mueller, Michael K.; Domschke, Wolfram

doi:10.1007/s10620-006-9267-1

Cited by 7 publications

(2 citation statements)

References 23 publications

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“…Spahn et al [9] reported a case of hemobilia associated with MPA similar to our case. In their case, a pseudoaneurysm was formed secondary to MPA at the branch of the right hepatic artery, and this pseudoaneurysm perforated the intrahepatic bile duct.…”

Section: Discussionsupporting

confidence: 86%

Gallbladder bleeding associated with microscopic polyangiitis: a case report

Kitaguchi

Kurata

Shimomura

et al. 2017

Journal of Surgical Case Reports

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A 71-year-old male who had a 6 years history of microscopic polyangiitis (MPA) was admitted to our hospital with a chief complaint of upper abdominal pain and nausea. Abdominal contrast-enhanced CT revealed extravasation of contrast medium in the gallbladder, and the patient was diagnosed with gallbladder bleeding. Although we started conservative treatment, anemia, hypotension and tachycardia had progressed gradually. Therefore, we performed emergent laparoscopic cholecystectomy on the following day. Intraoperative findings showed a remarkably distended gallbladder due to interior clots; however, the cholecystitis itself was not significant. Histopathological findings showed infiltrations of inflammatory cells around the blood vessels and vascular rupture. The postoperative course was uneventful. MPA is a type of ANCA-associated vasculitis. To the best of our knowledge, this is the first report of gallbladder bleeding associated with MPA. Spontaneous hemostasis cannot be expected, instead, surgical treatment must be performed promptly.

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Section: Discussionsupporting

confidence: 86%

Gallbladder bleeding associated with microscopic polyangiitis: a case report

Kitaguchi

Kurata

Shimomura

et al. 2017

Journal of Surgical Case Reports

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“…[14, 30] While gastrointestinal bleeding occurs in up to 21–29% of patients[52, 53], massive hemorrhage is rare. [54] Angiographic studies, although not routinely performed, have shown arterial aneursyms[54, 55] as a potential source of bleeding. Other gastrointestinal manifestations such as colonic ulcerations[56], intestinal ischemia[52, 57], and bowel perforation[52] have been reported.…”

Section: Clinical Featuresmentioning

confidence: 99%

Microscopic Polyangiitis

Chung¹,

Seo²

2010

Rheumatic Disease Clinics of North America

124

106

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Synopsis In 1923, Friedrich Wohlwill described two patients with a “microscopic form of periarteritis nodosa”, which was distinct from classical polyarteritis nodosa. This disease, now known as microscopic polyangiitis (MPA), is a primary systemic vasculitis characterized by inflammation of the small-caliber blood vessels and the presence of circulating antineutrophil cytoplasmic antibodies (ANCA). Typically, microscopic polyangiitis presents with glomerulonephritis and pulmonary capillaritis, although involvement of the skin, nerves, and gastrointestinal tract is not uncommon. Treatment of MPA generally requires use of a cytotoxic agent (such as cyclophosphamide) in addition to high-dose glucocorticoids. Recent research has focused on identifying alternate treatment strategies that minimize or eliminate exposure to cytotoxic agents. This article will review the history, pathogenesis, clinical manifestations, and treatment of MPA.

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Vaskuläre Erkrankungen

Stolte¹

2013

Pathologie

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Gastrointestinal Bleeding Secondary to Hepatic Artery Involvement of Microscopic Polyangiitis: Case Report and Review of the Literature

Cited by 7 publications

References 23 publications

Gallbladder bleeding associated with microscopic polyangiitis: a case report

Gallbladder bleeding associated with microscopic polyangiitis: a case report

Microscopic Polyangiitis

Vaskuläre Erkrankungen

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