J Korean Med Sci.  2005 Oct;20(5):899-900. 10.3346/jkms.2005.20.5.899.

Acute Appendicitis in Henoch-Schonlein Purpura: A Case Report

• Kim CJ
• Chung HY
• Kim SY
• Kim YO
• Ryu SY
• Kim JC
• Chung JH

• KMID: 1781781
• DOI: http://doi.org/10.3346/jkms.2005.20.5.899

Abstract

Common complications of Henoch-Schonlein purpura (HSP) that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Acute appendicitis is rarely seen as a complication of HSP. A sevenyear-old boy was admitted for arthralgia, abdominal pain, hematochezia, melena, and purpuric rash on the lower extremities. On admission day abdominal ultrasonography was normal, but on day 5, he became pyrexial and developed right iliac fossa pain and tenderness with guarding. Ultrasonography showed distended appendix surrounded by hyperechoic inflamed fat. On exploration an acutely inflamed, necrotic appendix was removed and grossly there was an appendiceal perforation in the appendiceal tip. Microscopically some of the small blood vessels in the submucosa showed fibrinoid necrosis with neutrophilic infiltrations. The authors report the case of a child who developed acute perforative appendicitis requiring appendectomy while on treatment for HSP.

Keyword

Purpura, Henoch-Schoenlein; Appendicitis; complications

MeSH Terms

Appendicitis/*diagnosis/*etiology
Child
Diagnosis, Differential
Humans
Male
Purpura, Schoenlein-Henoch/*complications/*diagnosis

Figure

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  Fig. 1 Submucosal blood vessel shows fibrinoid necrosis with neutrophilic infiltrations (H&E, ×150).

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