Abstract
We report a case of bleeding from the jejunal artery during Henoch-Schönlein purpura (HSP) treatment. A 64-year-old man who underwent total gastrectomy was repeatedly hospitalized owing to adhesive intestinal obstruction. He developed HSP in November 2013, for which steroid treatment was initiated. The patient developed abdominal pain and went into shock. His hemoglobin level decreased to 5.3 g/dl, and a contrast-enhanced computed tomography scan showed active hemorrhage from the jejunal artery. We attempted angiographic hemostasis unsuccessfully. Emergent laparotomy was then performed. The operative findings showed a hematoma of approximately 500 g mainly in the left upper abdomen, which was localized due to the adhesion. The jejunal artery ruptured into the mesojejunum, and the bleeding was active. We then performed ligation. The patient's postoperative course was uneventful, and he was transferred to our hospital's department of internal medicine for HSP treatment. Intraabdominal hemorrhage during HSP treatment is extremely rare and can be fatal, but we were able to save this patient's life because of the intraabdominal adhesion. The present case is reported in the context of relevant literature.
