title: [Hypersensitivity vasculitis causing an acute abdomen].
abstract: The members of a family of four persons suffered acute gastroenteritis after eating a meal consisting of chicken. While three of them recovered rapidly, the 18-year old son developed an acute abdomen which had to be treated surgically and led to a complicated stay at the intensive care unit. Intraoperatively, a mild insignificantly inflamed appendix and an obscure segmental inflammatory process of the small bowel with local peritonitis were seen; this required an appendectomy and a peritoneal lavage. The development of bacterial peritonitis with multiple organ dysfunction required several surgical revisions with an open abdominal toilet treatment. Histological examination of the resected appendix specimen showed a severe primary fibrinoid necrotizing vasculitis with epitheloid-granulomatous reaction. Diseases such as Panenteritis nodosa, Wegener's disease and Churg-Strauss's syndrome were excluded by negative serology. By a process of exclusion, a hypersensitivity vasculitis was diagnosed and treated successfully with a high-dose cortisone regime.
authors.affiliation: Abteilung für Chirurgie, Kaiser-Franz-Josef Spital der Stadt Wien, Osterreich.
authors.forename: S
authors.initials: S
authors.lastname: Hanelt
authors.forename: J
authors.initials: J
authors.lastname: Karner
authors.forename: P
authors.initials: P
authors.lastname: Peichl
authors.forename: W
authors.initials: W
authors.lastname: Hackl
authors.forename: M
authors.initials: M
authors.lastname: Klimpfinger
mesh_terms: D000006:Abdomen, Acute / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D000293:Adolescent; D001064:Appendicitis / Q000601:surgery; D001065:Appendix / Q000473:pathology / Q000601:surgery; D015267:Churg-Strauss Syndrome / Q000175:diagnosis; D003348:Cortisone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005759:Gastroenteritis / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D010538:Peritonitis / Q000382:microbiology / Q000601:surgery; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D003348:Cortisone