Spontaneous Rupture of the Liver Report of a Case Secondary to Polyarteritis Nodosa

Spontaneous liver rupture as first sign of polyarteritis nodosa

“…Some of the reported cases resolved the bleeding using vascular radiology techniques with selective artery embolization[12,13]. In other patients with hemodynamic stability expectant attitude was decided, administering blood transfusion after corticosteroid and immunosuppressive treatment[12,14-16]. In those cases in which surgical management was decided, most did not do any type of liver resection, opting for hepatic parenchyma hemostasis and packing[4,5] with high mortality rate.…”

Fatal intraperitoneal haemorrhage of hepatic origin

“…Congestion and inflammation of the hepatic parenchyma encountered in reticuloendothelial diseases such as advanced malaria makes hepatic rupture following minimal trauma of the enlarged liver more likely. Inflammatory changes associated with immunological disorders such as periarteritis nodosa (Dwonczyk et al, 1959) or a generalized Shwartzmann phenomenon (Huttunen et al, 1975) may also raise the tension within Glisson's capsule to a level sufficient to produce rupture of the liver, apparently spontaneously.…”

Polyarteritis nodosa of the liver: a report of two cases

“…These histological appearances are probably specific to PAN (Mowrey and Lundberg, 1954). Intra-and extrahepatic arterial aneurysms, which sometimes rupture, may occur (Dzwonczyk, Serlin and Skerrett, 1959;Kanter, 1965). The main effect of these changes on liver parenchyma is hepatic infarction which was noted in 15%/ of 230 cases by Mowrey and Lundberg (1954).…”