Rapid Communication| Volume 46, ISSUE 7, e27-e29, July 2011

Jejunal obstruction as initial presentation of polyarteritis nodosa in a 13-month-old boy


      Systemic polyarteritis nodosa (PAN) is a rare disease in childhood affecting small and midsized arteries. The typical presentation in children is of isolated 1- or 2-organ involvement, and the diagnosis is often based on the histopathology. We report a case of pediatric PAN whose presenting symptom was jejunal obstruction owing to ischemic necrosis of the small bowel. The postoperative recovery was uneventful, and the patient responded well to steroid therapy. There are only a few cases of PAN with intestinal involvement described in the literature, some of them fatal. The diagnosis of PAN should be considered in children with acute intestinal obstruction with no obvious etiology, as early recognition and treatment may reduce its high mortality.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ozen S.
        • Anton J.
        • Arisoy N.
        • et al.
        Juvenile polyarteritis: results of a multicenter survey of 110 children.
        J Pediatr. 2004; 145: 517-522
        • Ozen S.
        • Ruperto N.
        • Dillon M.J.
        • et al.
        EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides.
        Ann Rheum Dis. 2006; 65: 936-941
        • Talbot D.
        • Matenhelia S.
        • de la Hunt M.
        • et al.
        Paediatric enteritis as a presentation of infantile polyarteritis nodosa.
        Pediatr Surg Int. 1992; 7: 392-393
        • Mocan H.
        • Mocan M.C.
        • Sen Y.
        • et al.
        Fatal polyarteritis nodosa with massive mesenteric necrosis in a child.
        Clin Rheumatol. 1999; 18: 88-90
        • Oğuzkurt P.
        • Senocak M.E.
        • Ciftci A.O.
        • et al.
        Mesenteric vascular occlusion resulting in intestinal necrosis in children.
        J Pediatr Surg. 2000; 35: 1161-1164
        • Gündoğdu H.Z.
        • Kale G.
        • Tanyel F.C.
        • et al.
        Intestinal perforation as an initial presentation of polyarteritis nodosa in an 8-year-old boy.
        J Pediatr Surg. 1993; 28: 632-634
        • Chattopadhyay A.
        Intestinal perforation due to polyarteritis nodosa.
        Indian J Pediatr. 2001; 68: 297-298
        • De Carpi J.M.
        • Castejón E.
        • Masiques L.
        • et al.
        Gastrointestinal involvement in pediatric polyarteritis nodosa.
        J Pediatr Gastroenterol Nutr. 2007; 44: 274-278