Abstract
A 57-year-old woman who had peritoneal irritation sign and purpura of the legs underwent emergency operation because abdominal CT scan revealed a thickened bowel loop and ascites. A laparotomy demonstrated patchy redness in the entire small intestine. The diagnosis of Schönlein-Henoch purpura was confirmed by postoperative pathological examination of the biopsy specimen taken from the skin lesion. The other 74-year-old man who had abdominal rebound tenderness but no purpura of the extremities underwent emergency operation, because abdominal CT scan showed wall thickness of the intestine and ascites that was found to be bloody by abdominal paracentesis. At laparotomy, multiple redness and edema of the small intestine and transverse colon were demonstrated, and Schönlein-Henoch purpura was suspected. On the third postoperative day, purpura emerged in the legs ; however, pathological examination of this lesion did not confirm this disease. Additionally, upper gastrointestinal endoscopy and biopsy made the definite diagnosis of this disease.
To make diagnosis of this disease is difficult when abdominal pain is the chief complaint and purpura is absent, however, gastrointestinal endoscopy and biopsy are useful because pathologic examination of the biopsy specimen can show leukocytoclastic vasculitis or IgA deposition in vessel walls.
