2012 Volume 54 Issue 7 Pages 2022-2031
An 68-year-old woman was admitted to a hospital with purpura of the lower limbs and severe upper abdominal pain. Vomiting and massive melena were observed 23 days after admission, and she was immediately transferred to our hospital. Repeated massive bleeding from the jejunum occurred, for which emergency surgery was performed. Based on various clinical symptoms and histopathological findings of specimens from the resected jejunum, polyarteritis nodosa (PAN) was strongly suspected. Steroid pulse therapy, endoscopic hemostasis, and vascular embolization using catheters were conducted, but she died of massive gastrointestinal bleeding and multiorgan failure. As a result of the pathological anatomy, a final diagnosis of PAN was made. PAN, associated with gastrointestinal bleeding as the primary condition, is extremely rare, with its prognosis being poor. Prompt establishment of a diagnosis and intensive treatment are considered necessary.
