Polyarteritis nodosa and acute abdomen: A role for laparoscopy?

Mesenteric vasculitis secondary to polyarteritis nodosa represents an atypical but potentially life-threatening cause of bowel ischemia and acute abdomen. The patient presented with severe abdominal pain of recent onset, pitting edema of the legs, renal failure and bowel wall thickening suggestive of mesenteric ischemia on CT scan. Early laparoscopy allowed to rule out proximal bowel necrosis and resection was avoided. The patient was successfully managed with corticosteroid therapy and repeated hemodialysis sessions.