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Case Report



Upper gastrointestinal bleeding due to hepatic artery pseudoaneurysm in a patient with systemic lupus erythematosus

Yuksel Seckin, Yasir Furkan Cagin, Oguzhan Yildirim, Yilmaz Bilgic, Mehmet Ali Erdogan, Yahya Atayan.




Abstract

Inflammation of the vessels can result in the development of arterial aneurysms in patients with systemic lupus erythematosus (SLE). We present case of a 46 years-old women with SLE who developed three episodes of upper gastrointestinal (GI) bleeding due to hepatic artery pseudoaneurysm. Upper GI endoscopy showed a pulsating submucosal protrusion in the duodenal bulb. Abdominal ultrasound showed cystic lesions located at the hylus of the liver. On day 3 of admission, she had massive hematemesis again. Within the 24 hours hemoglobin level dropped from 10,5 g/dl to 5,5 g/dl despite several blood transfusion. Angiography of the celiac artery showed a 2x3 cm aneurysm originating from the common hepatic artery and the bleeding arose from rupture of a common hepatic artery aneurysm. Patient transfered to surgery for treatment and performed ligation of artery ligation. She died on the 10th postoperative day.

Key words: Systemic lupus erythematosus, hepatic artery pseudoaneurysm, upper gastrointestinal bleeding






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