Gastrointestinal manifestations and complications of Henoch-Schönlein purpura.

BACKGROUND Henoch-Schönlein purpura (HSP) is a systemic vasculitic disorder commonly affecting young children. Gastrointestinal (GI) involvement is frequently seen, and it varies from mild symptoms to severe complications. METHODS In the 5 years from July 1995 to June 2000, 208 children were diagnosed with HSP in our hospital. There were 116 males and 92 females with ages ranging from 9 months to 15 years (mean, 6.4 years; median, 5.5 years). Their medical records were reviewed. We focused on their gastrointestinal manifestations and complications. The hospital course and management of these patients were also analyzed. RESULTS GI manifestations were present in 162 cases (77.8%), and among them the most common presentation was colicky abdominal pain in 159 cases (98.1%), followed by vomiting in 64 cases (39.5%). Severe complications included massive GI bleeding in 5 patients, intussusception in 1, protein-losing enteropathy in 1, and a patient with pancreatitis. GI symptoms occurred before the manifestation of skin lesions in 41 patients (25.3%). Five of them underwent a laparotomy. Four cases were operated on due to suspicion of acute appendicitis or peritonitis. Another patient had an emergent operation due to ileo-ileo intussusception. CONCLUSIONS GI manifestations of HSP are common. Colicky abdominal pain was the most common GI manifestation of Henoch-Schönlein purpura. Some patients may have GI complications, but those requiring surgical intervention in our study were rare.