Colo‐colic intussusception associated with Henoch–Schönlein purpura in adults

Abstract

Henoch-Schönlein purpura (HSP) is often seen in childhood and is a self-limiting illness, and complication with intussusception is rare in adults. The case is reported of a 74-year-old man who was diagnosed with intussusception with HSP by ultrasonography on day of admission. Conservative therapy was started. However, his abdominal symptoms worsened, so he underwent laparotomy 3 days after admission. Histological study of the resected specimens demonstrated necrosis in the intussuscepted colon induced by HSP vasculitis. Bowel necrosis with intussusception in adult HSP is rare and might easily be overlooked. Thus special attention should be paid to gastrointestinal manifestations and, in an abdominal emergency, timely surgical intervention is life-saving.

Henoch-Schönlein Purpura With Intussusception in an Adult

“…8,9 Abdominal manifestation and GI involvement are common in children and adults. [15][16][17] In this case, ileocolic intussusception as the single initial manifestation in an adult patient has never been reported. 7,10 Intussusception is the most common GI complication of HSP during childhood.…”

Henoch-Schönlein purpura

“…In Japan, colo-colic intussusception associated with HSP in adults has been reported in two cases [13] . One of the cases underwent colonoscopy, and intussusception was reduced by colonoscopic insufflation [13] .…”

“…In Japan, colo-colic intussusception associated with HSP in adults has been reported in two cases [13] . One of the cases underwent colonoscopy, and intussusception was reduced by colonoscopic insufflation [13] . In contrast, intestinal ischemia, perforation, hemorrhage, fistulas, pancreatitis, and appendicitis are rare [9,14] .…”

The Evaluation and Management of Adult-Onset Henoch-Schonlein Purpura

“…Gastrointestinal bleeding is a serious complication that occurs more frequently in adults and may require transfusion or surgery [28]. Intussusception has also been reported in adults, albeit rarely, and may result in bowel necrosis [29].…”