Rupture of a inferior pancreaticoduodenal artery aneurysm as a complication of churg-strauss syndrome

Abstract

Churg-Strauss syndrome is a relatively rare disease that is characterized by bronchial asthma, eosinophilia, and periarteritis nodosa-like symptoms. We report a churg-Strauss syndrome case with a ruptured inferior pancreaticoduodenal artery aneurysm. A 49-year-old female was on oral steroid treatment due to Churg-Strauss syndrome. She developed abdominal pain. On examination, the entire abdomen was tender. On contrast-enhanced CT, a hematoma in the retroperitoneum and bleeding in the abdominal cavity were noted. The diagnosis of a ruptured inferior pancreaticoduodenal artery aneurysm was made, and embolization was immediately done. The patient was then treated conservatively. The patient's general condition improved, and she was started on full meals, but began vomiting. A diagnosis of duodenal obstruction was made, and she was treated conservatively. However, there was no improvement, and surgery was performed. Based on the intraoperative findings, removing the hematoma would have been difficult ; thus, a gastrojejunostomy was done. To the best of our knowledge, there have been no reports in Japan of Churg-Strauss syndrome complicated by abdominal cavity bleeding.