title: Surgical implications of Henoch-Schönlein purpura.
abstract: Intestinal intussusception, perforation, necrosis, and massive gastrointestinal bleeding are the surgical conditions most often seen in Henoch-Schönlein purpura (HSP). We reviewed the charts of 183 patients who were diagnosed with HSP at two children's hospitals over a 17-year period. Ten patients underwent laparotomy. Intussusception was the most common surgical lesion. Sequential barium enema and upper gastrointestinal series established the diagnosis of intussusception preoperatively in five of six patients. Two patients developed jejunal perforation and segmental ileal ischemia. Although gastrointestinal bleeding occurred in 52% of patients, the bleeding was self-limiting and no blood transfusion was required. Laboratory data were not helpful in differentiating patients with and without surgical problems.
authors.affiliation: Department of Surgery, Wilford Hall USAF Medical Center, San Antonio, TX.
authors.forename: D L
authors.initials: DL
authors.lastname: Cull
authors.forename: V
authors.initials: V
authors.lastname: Rosario
authors.forename: K P
authors.initials: KP
authors.lastname: Lally
authors.forename: I
authors.initials: I
authors.lastname: Ratner
authors.forename: G H
authors.initials: GH
authors.lastname: Mahour
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000601:surgery*; D007223:Infant; D007410:Intestinal Diseases / Q000209:etiology*; D007431:Intraoperative Complications; D007443:Intussusception / Q000209:etiology*; D008297:Male; D011300:Preoperative Care