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Colo-colic intussusception associated with Henoch-Schönlein purpura in adults
Fuminori Goda1, Takashi Maeba, Hisashi Usuki
1First Department of Surgery, Kagawa Medical University, Kagawa, Japan. fgoda@kms.ac.jp
Insights
Henoch-Schönlein purpura (HSP) rarely causes intussusception in adults. This case highlights the importance of recognizing gastrointestinal issues in adult HSP, as timely surgery can be life-saving.
Area of Science:
- Pediatrics
- Gastroenterology
- Rheumatology
Background:
- Henoch-Schönlein purpura (HSP) is a common childhood vasculitis.
- Intussusception is a rare complication of HSP, particularly in adults.
Observation:
- A 74-year-old male presented with intussusception and HSP, diagnosed via ultrasonography.
- Initial conservative management failed, leading to abdominal symptom exacerbation.
Findings:
- Laparotomy revealed intussuscepted colon with necrosis.
- Histology confirmed HSP vasculitis as the cause of bowel necrosis.
Implications:
- Adult intussusception secondary to HSP is uncommon and can be overlooked.
- Gastrointestinal manifestations in adult HSP require careful monitoring.
- Prompt surgical intervention is crucial for managing abdominal emergencies in adult HSP.
Abstract:
Henoch-Schönlein purpura (HSP) is often seen in childhood and is a self-limiting illness, and complication with intussusception is rare in adults. The case is reported of a 74-year-old man who was diagnosed with intussusception with HSP by ultrasonography on day of admission. Conservative therapy was started. However, his abdominal symptoms worsened, so he underwent laparotomy 3 days after admission. Histological study of the resected specimens demonstrated necrosis in the intussuscepted colon induced by HSP vasculitis. Bowel necrosis with intussusception in adult HSP is rare and might easily be overlooked. Thus special attention should be paid to gastrointestinal manifestations and, in an abdominal emergency, timely surgical intervention is life-saving.
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