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

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.