Rupture of a hepatic artery aneurysm caused by Wegener's granulomatosis.

Among vasculitis syndromes Wegener's granulomatosis (WG) is characterized by involvement of the upper and lower airways and kidneys. The associated vasculitis involves small and medium sized arteries and veins. Aneurysm formation and a segmental pattern of involvement of larger arteries is not typically seen in WG--a presentation more in keeping with polyarteritis nodosa. We report on a patient hospitalized with classical manifestations of WG who died suddenly of hypovolemic shock caused by intraperitoneal hemorrhage resulting from rupture of a hepatic artery aneurysm. The aneurysm was caused by involvement of the hepatic artery in the disease process. To our knowledge aneurysmatic dilatation of the hepatic artery due to WG has not been previously described. This case illustrates an unusual disease course in WG and the overlap which exists in classical vasculitis syndromes.