Document Detail

Gangrenous appendicitis in a child with Henoch-Schonlein purpura.
MedLine Citation:
PMID:  18970918     Owner:  NLM     Status:  MEDLINE    
Abdominal pain is common feature of Henoch-Schonlein purpura, which may mimic appendicitis, leading to unnecessary laparotomy. Accordingly, the diagnosis must be confirmed by ultrasonography or computed tomography scan before laparotomy is performed. The authors report a case of simultaneous occurrence of Henoch-Schonlein Purpura and gangrenous appendicitis in an 18 year-old boy. The patient was admitted with abdominal pain, cramps, and mild dehydration. He also complained of small reddish purple on his lower limbs, bilateral knee pain, low-grade fever, as well as bloody stools. The symptoms subsided completely. Eight days later, he returned with nonbloody, nonbilious emesis, abdominal cramps, and right lower quadrant abdominal tenderness. Abdominal ultrasound evaluation was performed to rule out an intussusception but demonstrated appendiceal dilatation with a possible appendicolith without any evidence of intussusception. A laparotomy was undertaken, and appendectomy was performed for gangrenous appendicitis. Simultaneous occurrence of Henoch-Schonlein purpura and acute appendicitis is rarely observed. Clinical features of the patients may mislead the clinicians, resulting in delayed diagnosis or misdiagnosis. The use of ultrasonography and computed tomography scan would confirm the diagnosis before surgery.
Ali Jangjoo; Ahmad Amouzeshi; Ali Najib Jalali
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e33-5     Citation Subset:  IM    
Department of General Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
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MeSH Terms
Abdominal Pain / etiology
Anti-Bacterial Agents / therapeutic use
Appendicitis / complications,  diagnosis*,  drug therapy,  pathology,  surgery,  ultrasonography
Arthralgia / etiology
Ceftriaxone / therapeutic use
Combined Modality Therapy
Diagnosis, Differential
False Negative Reactions
Fever / etiology
Gastrointestinal Hemorrhage / etiology
Hydrocortisone / therapeutic use
Intussusception / diagnosis
Metronidazole / therapeutic use
Prednisone / therapeutic use
Purpura, Schoenlein-Henoch / complications*,  drug therapy
Reg. No./Substance:
0/Anti-Bacterial Agents; 443-48-1/Metronidazole; 50-23-7/Hydrocortisone; 53-03-2/Prednisone; 73384-59-5/Ceftriaxone

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