Answer of April 2000

Clinical History:

Young man admitted for GIB.

Figure 1 Celiac angiogram
Figure 2 SMA

What is your diagnosis?

                           Figure 1                                                                Figure 2

Diagnosis:

Polyarteritis nodosa

Discussion:

Figure 1 The celiac angiogram shows multiple small peripheral situated saccular aneurysms in the liver.

Figure 2 The superior mesenteric angiogram is normal.

Patient was opened up with no cause of GI bleeding identified. Surgical biopsy of the stomach and small bowel confirmed the diagnosis of polyarteritis nodosa. The GIB is presumably from rupture of the small mesenteric aneurysms.