Polyarteritis Nodosa Complicated with Bleeding and Perforation of the Duodenal Ulcer

Eiji Kanehira, Yukimitsu Kawaura, Kenji Ohmura, Hiroshi Hikishima, Teruaki Ushijima, Ichirou Nakano, Ushio Yazaki, Takashi Iwa

Department of Surgery 1, Kanazawa University School of Medicine

A 54-year-old male was admitted to receive hemodialysis for his severe renal failure. When he began to have hematemesis and bloody stools, panendoscopy detected considerable bleeding from a duodenal ulcer. As repeating hemostasis through the panendoscope was not effective, the patient was referred to us for surgery. Laparotomy revealed a very fresh perforation on the anterior wall of the duodenal bulb, and distal partial gastrectomy was carried out. Because histopathological findings led to a diagnosis of polyarteritis nodosa, steroid administration was initiated. The patient got through the risky postoperative period without serious complications. When arteritis affects the gastrointestinal region, ulceration, necrosis, and perforation are known to be its major complications. While arteritis is observed mostly in the jejunum or ileum, the duodenum is an occasional site of the disease.

Key words
polyarteritis nodosa, bleeding and perforation of duodenal ulcer

Reprint requests
Eiji Kanehira Department of Surgery 1, Kanazawa University School of Medicine
13-1 Takaramachi, Kanazawa, 920 JAPAN

Accepted
April 11, 1990

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