Terminal Ileitis Induced by Henoch–Schonlein Purpura That Presented as Acute Appendicitis

Tian, Xiaofeng; Jy, Pan; Li, Yang; Jing, Huirong

doi:10.1097/md.0000000000000492

Cited by 12 publications

(11 citation statements)

References 14 publications

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“…There was an adult case report with HSP terminal ileitis and presented with symptoms mimicking appendicitis. [6] Pneumatosis was also detected on his abdominal CT. In our case study, we presented a case report on the early detection of PI in a child with HSP using bedside ultrasound in the emergency department.…”

Section: Discussionmentioning

confidence: 94%

“…[13] It is relatively more difficult to detect sub-serosal air especially if intraluminal air is prominent. [6] Thus, both long-axis and short-axis views of the bowel are used to confirm the presence of intramural and sub-serosal air (Figure 1). For our patient, the edematous bowel loops were fluid filled and intramural air was easily appreciated.…”

Section: Discussionmentioning

confidence: 99%

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Point-of-care ultrasound identification of pneumatosis intestinalis associated with Henoch-Schönlein purpura gastrointestinal involvement: A case report

Tan

James

Warier

et al. 2021

World Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasound identification of pneumatosis intestinalis associated with Henoch-Schönlein purpura gastrointestinal involvement: A case report

Tan

James

Warier

et al. 2021

World Journal of Emergency Medicine

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“…HSP accompanied by terminal ileitis should prompt consideration to a broad differential diagnosis and investigation, including Crohn's disease, vasculitic syndromes, infections, 1 appendicitis and, especially, intussusception. 12,13 Abdominal findings were not compatible with emergent conditions, such as appendicitis or intussusception.…”

Section: Differential Diagnosismentioning

confidence: 99%

Terminal Ileitis: A Rare Complication of Henoch-Schönlein Purpura in Children

Mano

Santos

Limão

et al. 2021

Gaz Med

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Henoch–Schönlein purpura (HSP) is characterized by nonthrombocytopenic palpable purpura, arthritis or arthralgia, and gastrointestinal and/or renal involvement. Gastrointestinal symptoms are reported in 50%-75% and they are related to a previous group A streptococcal infection in 40%. A healthy 5-year-old girl presented with a three-week history of a recurrent purpuric rash on the lower limbs, arthralgia and angioedema, without renal involvement. During the third relapse, she had severe, diffuse and persistent abdominal pain and bloody stools. An abdominal ultrasound revealed transmural edema of the last ileal segment, compatible with ileitis. She received prednisolone for five days, with full clinical recovery. Antistreptolysin O titer was elevated. The remaining laboratory tests were normal (antinuclear, anti-neutrophil and anti-Saccharomyces cerevisiae antibodies; rheumatoid factor; stool cultures, parasitological examination and viral antigen tests). One month later, an abdominal ultrasound revealed no abnormalities. Terminal ileitis is a very rare complication of HSP in children but has a good prognosis.

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“…Knowing that bowel perforation in children with HSP usually occurs due to intussusception and is in the small intestine, we report a rare case of HSP in a 42-year old female with rectal perforation who was admitted with abdominal pain and pus discharge during defecation. Terminal ileitis has been reported rarely in the literature (4,11,12). Crohn disease and PID were the other differential diagnosis in this patient but since, according to her history, about 9 months ago she divorced and did not have any subsequent sexual activity, PID was ruled out.…”

Section: Case Reportmentioning

confidence: 99%

“…HSP mostly occurs in children between the ages of 3 and 15 years (2) and is less common in adults (3). The incidence of 3.4 to 14.3 per million was reported for HSP in adults (4). HSP manifestations in children include palpable purpura, arthritis or arthralgia, renal disease and abdominal pain (5).…”

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confidence: 99%

Rectal perforation in a 42-year-old woman due to Henoch-Schönlein purpura: a case report

et al. 2017

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SUMMARYHenoch-Schönlein purpura (HSP) is caused by deposition of IgA-containing immune complexes within the blood vessels. HSP mostly occurs in children and is less common in adults. In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children. These can be caused by gastrointestinal hemorrhage, bowel ischemia and necrosis, intussusception, and bowel perforation. In adults, intussusception is less frequent than in children. We report a 42-year-old woman referred to our hospital with acute abdominal pain. After laboratory and radiologic examinations, laparatomy was performed which revealed rectal perforation due to HSP. HSP is a multisystem disorder. Abdominal pain in patients with HSP may herald a serious gastrointestinal problem also in adult patients. Key words:Henoch-Schönlein purpura; Bowel perforation; Abdominal pain; Rectal perforation. Reumatismo, 2017; 69 (3): 131-133 n INTRODUCTION H enoch-Schönlein purpura (HSP), also called IgA vasculitis, is caused by deposition of IgA-containing immune complexes within the blood vessels (1) and its characteristic finding is leukocytoclastic vasculitis. HSP mostly occurs in children between the ages of 3 and 15 years (2) and is less common in adults (3). The incidence of 3.4 to 14.3 per million was reported for HSP in adults (4). HSP manifestations in children include palpable purpura, arthritis or arthralgia, renal disease and abdominal pain (5). Gastrointestinal symptoms like nausea, vomiting, abdominal pain, and transient paralytic ileus occur in 50% of the children and the findings are: gastrointestinal hemorrhage; bowel ischemia and necrosis; intussusception, and bowel perforation (6). In adults, in addition to the above-mentioned manifestations, there are two main differences: intussusception is rare and the risk of renal disease is increased (7). The diagnosis of HSP is usually based on clinical manifestations, especially palpable purpura in the lower extremities and a biopsy of the involved organ (e.g., skin or kidney) in those who have unusual presentations. There is no specific diagnostic laboratory test (8). Imaging is commonly performed on patients with abdominal pain. Abdominal radiography may show dilatation of the bowel loops; it may demonstrate peritoneal fluid, hematomas, intussusception and an increased bowel wall thickness (9). We report a rare case of rectal perforation due to HSP in a 42-year-old woman. n CASE REPORTA 42-year-old woman with chief complaint of abdominal pain, was referred to Rasool-e-Akram hospital in February 2015. Her pain had started gradually a week before in the hypogastric region re- We report a 42-year-old woman referred to our hospital with acute abdominal pain. After laboratory and radio logic examinations, laparatomy was performed which revealed rectal perforation due to HSP. risk of renal disease is increased (7). The u s e blood vessels. HSP mostly occurs in children and is less common in adults. In addition to palpable purpura, u s e...

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Terminal Ileitis Induced by Henoch–Schonlein Purpura That Presented as Acute Appendicitis

Cited by 12 publications

References 14 publications

Point-of-care ultrasound identification of pneumatosis intestinalis associated with Henoch-Schönlein purpura gastrointestinal involvement: A case report

Point-of-care ultrasound identification of pneumatosis intestinalis associated with Henoch-Schönlein purpura gastrointestinal involvement: A case report

Terminal Ileitis: A Rare Complication of Henoch-Schönlein Purpura in Children

Rectal perforation in a 42-year-old woman due to Henoch-Schönlein purpura: a case report

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