Hepatic haematoma in polyarteritis nodosa

Abstract

A 21-year-old man presented two years ago with upper abdominal discomfort, anorexia, weight loss and low grade fever. He was hypertensive and had a right foot drop and hepatosplenomegaly. Polyarteritis nodosa was diagnosed on muscle biopsy but a liver biopsy was normal. Regression of symptoms followed treatment with corticosteroids and methyldopa. In 1974, whilst in hospital for treatment of Vincent's angina, he suddenly became shocked with upper abdominal pain. His liver became enlarged and tender. Transfusion produced a rapid recovery. The following day a liver scan was performed (Fig. 1). A week later he suffered a similar episode requiring further transfusion. Abdominal angiography was then performed and demonstrated the changes of polyarteritis nodosa in the liver (Figs. 2–3) without other visceral involvement.