PubMed1977
Three cases of polyarteritis nodosa (P.A.N.) studied by abdominal arteriography with a follow-up examination between the 6th and 9th month are reported. In the first case, the initial arteriogram showed only the appearances of endarteritis. The second arteriogram, 9 months later, following a worsening of general condition, revealed diffuse aneurysms in the abdomen. In the second patient, who had multiple aneurysms at the time of the initial examination, arteriography agter 6 months following a new episode of the disease with an acute abdominal syndrome and collapse revealed, alongside the multiplication of the aneurysms with rupture of one of them, the disappearance of some ectasias with the obliteration of certain arteries. In the third patient, the follow-up arteriogram after treatment showed disappearance of the renal arteriograms which the first study had revealed 7 months before. These three cases give an idea of the different radiological appearances of P.A.N. The appearance of endarteritis with no specific characteristics indicates and inflammatory localisation of the disease. This is an initial stage leading to ectasia. Aneurysms may progress to rupture or may multiply. Endarteritis and ectasia may also progress towards scarring and disappear. A method of early diagnosis, arteriography makes it possible to institute treatment before the lesions reach a stage at which they must inevitably develop either into aneurysms or lead to obstruction with distal ischaemia.