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Massive gastric hemorrhage: an unusual complication of Henoch-Schönlein purpura
Journal of Pediatric Surgery
|October 1, 1983
Insights
Severe Henoch-Schönlein purpura (HSP) can cause massive upper gastrointestinal bleeding in children. Aggressive surgical and interventional management, including embolization, is crucial for survival.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
- Vascular Interventions
Background:
- Henoch-Schönlein purpura (HSP) is a common vasculitis affecting children, typically presenting with rash, arthritis, and abdominal pain.
- Multisystem involvement in severe HSP cases can lead to life-threatening complications, including upper gastrointestinal hemorrhage.
Observation:
- Two severely ill children with multisystem HSP experienced massive upper gastrointestinal bleeding due to gastric stress ulcers.
- Initial management involved operative ligation of ulcers, vagotomy, and pyloroplasty.
Findings:
- Recurrent hemorrhage in one child necessitated arteriographic embolization, leading to successful hemostasis.
- Both children survived, highlighting the efficacy of combined surgical and interventional approaches.
Implications:
- Aggressive and multidisciplinary management is essential for addressing severe gastrointestinal complications in pediatric HSP.
- Early consideration of advanced interventions like embolization can be life-saving in refractory cases.
Abstract:
Two severely ill children with multisystem involvement of Henoch-Schönlein purpura developed massive upper gastrointestinal hemorrhage, requiring operative ligation of gastric stress ulcers, and vagotomy and pyloroplasty. Arteriographic embolization was also used in one of the children when she developed recurrent hemorrhage. Survival in both children emphasizes the need for aggressive management of the many complications these children may develop.