Fatal Intra-abdominal Hemorrhage in Eosinophilic Granulomatosis with Polyangiitis: An Autopsy Case Report

A 76-year-old woman was admitted to our hospital due to a relapse of eosinophilic granulomatosis with polyangiitis (EGPA). On day 4 of hospitalization, the patient developed hypotension and anemia. Contrast-enhanced computed tomography (CT) revealed an intra-abdominal hematoma with contrast extravasation near the right gastroepiploic artery. The patient died despite receiving emergency embolization and intensive care. An autopsy revealed eosinophilic necrotizing vasculitis widely distributed in multiple organs. No vasculitis was found in the gastroepiploic artery, suggesting that vasa vasorum involvement may have contributed to the arterial rupture. This case report describes a rare instance of a fatal hemorrhage associated with EGPA.