多發性肝動脈血管瘤：一全身性紅斑性狼瘡之不尋常表徵

Multiple hepatic artery aneurysms : an unusual manifestation of systemic lupus erythematosus

A 35 year-old woman has systemic lupus erythematosus (SLE) with positive antiphospholipid antibody for more than 10 years. She was hospitalized due to infarction at left thalamus and left temporal-occipital junction with presentation of right hemianopsia, and hemiplegia. She gradually regained her muscle power of right limbs 1 week later. She developed a sudden severely sharp epigastric pain accompanied with cold sweating and hypotension 2 weeks after admission. An abdomen computed tomography (Fig. 1) showed multiple contrast poolings (white arrow) in bilateral lobes of liver in arterial phase, suggest rupture of hepatic artery microaneurysms (black arrow) and resulting in subcapsular hematoma (asterisk). Angiography of common hepatic artery revealed multiple variable-sized microaneurysms over almost every branches of right hepaticartery (Fig. 2A) and left hepatic artery (Fig. 2B). Contrast extravasation from the inferior branch of right hepatic artery (arrow in Fig. 2A) and left hepatic artery (arrow in Fig. 2B) to the corresponding areas indicated microaneurysms rupture. Her hemodynamics was stabilized after successful transarterial embolization.