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October 1968

Successful Surgical Treatment of Massive Abdominal Hemorrhage Due to Periarteritis Nodosa

Author Affiliations

From the Department of Surgery, Johns Hopkins University School of Medicine, and Johns Hopkins Hospital, Baltimore.

Arch Surg. 1968;97(4):541-543. doi:10.1001/archsurg.1968.01340040037004

MASSIVE free intra-abdominal hemorrhage secondary to periarteritis nodosa is rare and almost uniformly fatal. The purpose of this communication is to report the case of a patient who suffered rupture of an aneurysm of the middle mid-colic artery secondary to periarteritis nodosa. Early and prompt surgical intervention was successful in preventing sudden death. After review of the literature, we believe this to be the first successfully treated case of free intraperitoneal rupture of such an aneurysm.

Report of a Case  A 37-year-old white married woman (119 92 34) was admitted to the Johns Hopkins Hospital as an emergency on May 11, 1966. She was complaining of severe pain in the lower portion of the back. The patient had been asymptomatic until one week prior to admission when back pain developed over the lumbosacral area. The pain was dull in character, did not radiate, and was persistent. She had also noticed