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Acute appendicitis in two children with Henoch-Schönlein purpura

Salim Bilici1, Cihangir Akgun, Mehmet Melek

  • 1Departments of Pediatric Surgery, Yuzuncu Yil University School of Medicine, Van, Turkey.

Paediatrics and International Child Health
|November 21, 2012
PubMed

Insights

Henoch-Schönlein purpura (HSP) can cause abdominal pain mimicking appendicitis. Rare cases of HSP with suppurative appendicitis highlight the need for thorough investigation in affected children.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Surgery
  • Rheumatology

Background:

  • Henoch-Schönlein purpura (HSP) is a systemic vasculitis often affecting the gastrointestinal tract.
  • Gastrointestinal involvement in HSP can present with abdominal pain, mimicking surgical emergencies like appendicitis.

Observation:

  • Two pediatric cases are presented: a 13-year-old boy and a 12-year-old girl, both with HSP and abdominal pain.
  • Despite initial treatment for HSP, both patients underwent laparotomy revealing acute suppurative appendicitis.
  • Vasculitic lesions were noted in the ileum of both patients, suggesting a link between HSP and appendiceal inflammation.

Findings:

  • Suppurative appendicitis is a rare but significant complication of Henoch-Schönlein purpura.
  • Ileal and colonic vasculitis in HSP can present with symptoms indistinguishable from acute appendicitis.
  • Standard HSP treatment did not resolve the appendicitis symptoms in these cases.

Implications:

  • Clinicians should consider suppurative appendicitis in pediatric patients presenting with HSP and abdominal symptoms.
  • Diagnostic imaging, such as ultrasonography, is crucial for differentiating HSP-related gastrointestinal issues from appendicitis.
  • Early and accurate diagnosis is vital to prevent unnecessary appendicectomy and ensure appropriate management of HSP complications.

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