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Henoch-Schönlein purpura with intussusception: a case report
1Department of Pediatrics, Show Chwan Memorial Hospital, Chang-Hwa, Taiwan. sinped@yahoo.com.tw
Pediatrics and Neonatology
|March 16, 2010
Summary
Henoch-Schönlein purpura (HSP) can cause gastrointestinal issues like intussusception, a rare but common surgical complication. This case highlights successful manual reduction of ileocecal intussusception in a pediatric patient with HSP.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
- Rheumatology
Background:
- Gastrointestinal symptoms are frequent in Henoch-Schönlein purpura (HSP), affecting up to two-thirds of patients.
- Surgical intervention for HSP-related GI issues is uncommon, with intussusception being the most frequent indication.
- Intussusception, a serious condition where one part of the intestine slides into another, requires prompt management.
Observation:
- A 3-year-old boy presented with a 4-day palpable skin rash, 3-day fever, intermittent abdominal pain, and transient left ankle arthralgia, consistent with HSP.
- Abdominal sonography revealed classic intussusception signs: a 'doughnut sign' and 'pseudo-kidney sign' in the right upper quadrant.
- Initial attempts at non-surgical reduction using air enema were unsuccessful.
Findings:
- The patient underwent surgical reduction for ileocecal intussusception.
- Manual reduction of the intussusception was successfully achieved without the need for bowel resection.
- This demonstrates the feasibility of non-resectional surgical management for intussusception in HSP.
Implications:
- Highlights the importance of recognizing intussusception as a potential surgical emergency in pediatric HSP.
- Suggests that prompt surgical intervention, including manual reduction, can be effective in managing HSP-induced intussusception.
- Emphasizes the role of advanced imaging like abdominal sonography in diagnosing intussusception in this context.
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