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Kim: Henoch-Schönlein Purpura Presenting as Intussusception
Case Report

The Korean Journal of Gastroenterology 2017; 69(6): 372-376.

Published online: 23 June 2017

DOI: https://doi.org/10.4166/kjg.2017.69.6.372

Henoch-Schönlein Purpura Presenting as Intussusception

Keun Young Kim1, 2

1Department of Surgery, Wonkwang University School of Medicine, Iksan, Korea.

2Institute of Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

Correspondence to: Keun Young Kim, Department of Surgery and Institute of Medical Science, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 54538, Korea. Tel: +82-63-859-0644, Fax: +82-63-855-2386, saint@wonkwang.ac.kr

Received 12 May 2017       Revised 24 May 2017       Accepted 5 June 2017

Copyright © 2017. Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Henoch-Schönlein purpura (HSP) is systemic vasculitis disease with various clinical manifestations. Gastrointestinal symptoms in patients with HSP are usually common, with an incidence rate of 62-90%. Most of these gastrointestinal symptoms occur after typical skin purpura, which is a very important clinical evidence for making a diagnosis of HSP. It is difficult to diagnose HSP without skin rash. About 25% of patients may experience gastrointestinal symptoms as their first symptoms. Herein, we report a case of ileo-colic intussusception associated with HSP in a 5-years-old girl presented with diffuse abdominal distension. Our patient did present any symptoms of HSP, such as purpura, arthralgia or arthritis, before surgery.

Keywords: Henoch-Schonlein purpura, Ileus, Intussusception

Figures and Tables

Fig. 1

Abominopelvic X-ray findings. (A) Supine simple abdomen showing dilated loops of the small intestine and bowel edema. (B) Erect simple abdomen showing multiple air-fluid levels with a step ladder sign.

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Fig. 2

Abdominopelvic computed tomography finding. Coronary view showing severe dilated small intestine and ileo-colic intussusception with target sign (arrow).

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Fig. 3

Operative findings. (A) Before manual reduction. The ileocolic type intussusception is observed (arrow). (B) After manual reduction. Severe hemorrhagic infarction in the small intestine is observed (arrow).

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Fig. 4

Patient's skin lesion. Various forms of skin purpura are observed at (A) the arm, and (B) the knee.

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Fig. 5

Microscopic findings of the ileum. Inflammation is observed around the submucosal vessels (circle) (H&E, ×200).

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Notes

Financial support This paper was supported by Wonkwang University 2016.

Conflict of interest None.

References

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