Learning objectives
Understand current vasculitis classification and their main etiologic mechanisms.
Describe the main abdominal vascular territories compromised by abdominal vasculitis,
as well as their clinical manifestations and possible complications.
Recognize the most important and frequent CT findings in abdominal vascultitis.
Background
Vasculitis is an inflammation of the blood vessel walls that can be primary (idiopathic or causal mechanism poorly understood) or secondary to another underlying process (infections,
drugs,
connective tissue diseases).They are classified in different ways,
being the size of the vessel one of the most commonly used; vasculitis of large vessels (aorta and its major branches),
medium vessel vasculitis (visceral arteries and their branches) and small vessel vasculitis (arterioles,
venules and capillaries).
Besides,
they may be classified according to the presence of certain antibodies and...
Findings and procedure details
Polyarteritis Nodosa (PAN)
It is a necrotizing vasculitis that is characterized by the presence of multiple aneurysms (approximately 50-60%) due to erosion and weakening of the arterial wall by the inflammatory process.
This vasculitis most commonly affects the kidney (80-90%),
followed by the gastrointestinal tract (GIT) (50-70%),
liver (50-60%) and spleen (45%).
Two thirds of patients present symptoms like abdominal pain,
nausea and vomiting associated with organ damage secondary to ischemia or infarction,
causing manifestations such as hypertension,
peripheral neuropathy,
heart failure,
skin nodules,
among...
Conclusion
It is important for the radiologist to know the principal vasculitis that may occur with abdominal involvement because these can mimic several pathologies.
Although some of their CT findings are non-specific,
sometimes they show particular characteristics that lead to the correct diagnosis.
References
1.Mahr A,
de Menthon M.
Classification and classification criteria for vasculitis: achievements,
limitations and prospects.
Curr Opin Rheumatol 2015; 27:1-9.
2.
Ha HK,
Lee SH,
Rha SE,
et al.
Radiologic features of vasculitis involving the gastrointestinal tract.
RadioGraphics 2000; 20:779–794.
3.Yazisiz V.
Similarities and differences between Behçet’s disease and Crohn’s disease.
World J Gastrointest Pathophysiol 2014; 5(3):228–238
4.Kirby,
John M.
et al.
Abdominal Manifestations of Systemic Lupus Erythematosus: Spectrum of Imaging Findings.
Can Assoc Radiol J.
2009 Jun; 60(3) : 121 - 132
5.Hellman.
Giant...