HEPATIC HEMORRHAGE IN MALIGNANT RHEUMATOID-ARTHRITIS

Intrahepatic hemorrhage is a serious and life-threatening complication in liver disease. We describe a patient who had two episodes of intra hepatic hemorrhage after having malignant rheumatoid arthritis for 8 y r. Abdominal CT scans revealed a large intrahepatic, subcapsular hemat oma. Arteriography demonstrated irregularity, caliber change, and pseu doaneurysms of the right hepatic artery, suggesting vasculitis as a ca use of the bleeding. The hemorrhage was first treated with transcathet er arterial embolization, which failed to exert long term control, but arterial infusion of a large dose of prednisolone when the hemorrhage appeared was successful in managing it.