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Ultrasonography to diagnose and exclude intussusception in Henoch-Schönlein purpura

S C Hu1, M S Feeney, M McNicholas

  • 1Department of Paediatric Surgery, Children's Hospital, Dublin, Republic of Ireland.

Archives of Disease in Childhood
|September 1, 1991
PubMed

Insights

Abdominal pain in Henoch-Schönlein purpura may indicate intussusception. Ultrasound aids early diagnosis and monitoring of this complication in children.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Rheumatology
  • Medical Imaging

Background:

  • Henoch-Schönlein purpura (HSP) is a common childhood vasculitis.
  • Abdominal pain is a frequent symptom in pediatric HSP, often necessitating investigation for gastrointestinal complications.
  • Intussusception and bowel perforation are serious concerns in children with HSP.

Observation:

  • A retrospective review of 152 children diagnosed with HSP over 11 years was conducted.
  • Sixty children experienced abdominal pain, 19 had gastrointestinal bleeding, and 9 had suspected intussusception.
  • Ultrasonography confirmed intussusception in 2 of the 9 suspected cases.

Findings:

  • Ultrasound is a valuable tool for the early diagnosis of intussusception complicating Henoch-Schönlein purpura.
  • In cases of "loose" intussusception, expectant management with close monitoring may lead to spontaneous reduction.
  • Ultrasound can also monitor for postoperative intussusception recurrence, mural hematoma, and uncomplicated intestinal vasculitis.

Implications:

  • Early and accurate diagnosis of intussusception in HSP is crucial for appropriate management.
  • Ultrasonography offers a non-invasive method for diagnosing and monitoring gastrointestinal complications in pediatric HSP.
  • Expectant management guided by ultrasound may be a viable option for select cases of intussusception in HSP, potentially avoiding surgical intervention.

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