The value of ultrasound in Schoenlein-Henoch purpura

Pery, M; Alon, Uri; Lachter, Jesse; Kaftori, Joseph K.; Gaitini, Diana; Rosenberger, A.

doi:10.1007/bf02072045

Cited by 18 publications

(19 citation statements)

References 9 publications

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“…Ultrasound examination often reveals significant thickening of the bowel wall accompanied by reduced peristalsis and dilated bowel loops. Some patients have a small amount of intraperitoneal ascites (26). The same results were also found by abdominal CT in one case.…”

Section: Discussionsupporting

confidence: 80%

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Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients

Lin

et al. 2004

Acta Paediatrica

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Section: Discussionsupporting

confidence: 80%

“…Improved or relapsed bowel wall thickness, and other sonographic abnormalities, correlates well with clinical progress (27). Routine abdominal radiographs are not recommended, unless perforation is clinically suspected (26).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients

Lin

et al. 2004

Acta Paediatrica

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“…One can detect asymmetrical bowel wall thickening, dilatation, hypomotility, as well as intraperitoneal fluid collections and intussusception [97,103,104]. The evolution of the disease can be followed noninvasively.…”

Section: Diagnosis Of Gi Diseasesmentioning

confidence: 97%

“…LCV involving the gallbladder may cause acute acalculous cholecystitis [95,96] as well as marked thickening of the gallbladder wall [97]. Hydrops of the gallbladder has been described with spontaneous resolution [98].…”

Section: Gi Features Of Hspmentioning

confidence: 99%

Gastrointestinal Manifestations of Henoch-Schonlein Purpura

2008

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Henoch-Schonlein Purpura (HSP) is the most common systemic vasculitis in childhood. The diagnostic criteria include palpable purpura with at least one other manifestation -- abdominal pain, IgA deposition, arthritis or arthralgia, or renal involvement. Immune complex deposits result in necrosis of the wall of small- and medium-sized arteries with infiltration of tissue by neutrophils and deposition of nuclear fragments, a process called leukocytoclastic vasculitis (LCV). It is often associated with infections, medications, or tumors. It may coexist with or mimic Crohn's disease. Periumbilical and epigastric pain worsens with meals, from bowel angina. Bleeding is usually occult or, less commonly, associated with melena. Intussusception, the most common surgical complication, is usually ileo-ileo or ileo-colic. Perforations, usually ileal, may occur spontaneously or be associated with intussusception. Ultrasound, recommended as the first diagnostic test, and CT scans may show intussusception and asymmetric bowel wall thickening mainly involving the jejunum and ileum. There are a range of endoscopic findings including gastritis, duodenitis, ulceration, and purpura, with the second portion of the duodenum characteristically being involved more than the bulb. Intestinal biopsies show IgA deposition and LCV in the submucosal vessels. Superficial biopsies may show inflammation, ulceration, edema, hemorrhage, and vascular congestion, presumably due to vasculitis-induced mucosal ischemia. The efficacy of corticosteroids in preventing severe complications or relapses is controversial. The majority of patients, however, improve spontaneously.

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“…The frequency in one retrospective series was up to 9% of children suffering from HSP [9]. Particularly, sonographic characteristics of cholecystitis were found by several investigators, similar to our patient [10,11]. However, there are only two previous reports of histologically proven HSP gallbladder vasculitis in the literature [2,3].…”

Section: Discussionmentioning

confidence: 53%

Gallbladder Involvement of Henoch-Schönlein Purpura Mimicking Acute Acalculous Cholecystitis

Hoffmann¹,

Cremer²,

Preiß³

et al. 2004

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Background/Aims: We report the case of a 53-year-old man with fever and severe abdominal pain following an upper respiratory tract infection. Methods/Results: The clinical signs, the laboratory markers, and the ultrasound findings were consistent with acute acalculous cholecystitis and he underwent cholecystectomy. Histologically the gallbladder showed vasculitis and the patient developed postoperatively a purpuric rash of the legs with transient ankle arthritis. Gastroscopy revealed prepyloric ulcers consistent with vasculitis. The patient was diagnosed as having Henoch-Schönlein purpura. Gastric ulcers as well as arthritis disappeared upon treatment with corticosteroids and proton pump inhibitors. Conclusion: Taken together, Henoch-Schönlein purpura can mimic acute cholecystitis and should be considered as a rare differential diagnosis of acute cholecystitis.

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The value of ultrasound in Schoenlein-Henoch purpura

Cited by 18 publications

References 9 publications

Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients

Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients

Gastrointestinal Manifestations of Henoch-Schonlein Purpura

Gallbladder Involvement of Henoch-Schönlein Purpura Mimicking Acute Acalculous Cholecystitis

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