Abstract
Perforation of the intestine in patients with Henoch-Schönlein purpura (HSP) has recently attracted attention as a surgical emergency. This is a case report of HSP associated with multiple perforations of the ileum. A 5-year-old boy was seen at the deopartment of pediatrics in our hospital because of abdominal pain and vomitting, and was admitted with a diagnosis of HSP. The patient developed generalizes peritonitis and was transfered to the department. Upon emergency laparotomy four perforations were noted at the terminal ileum. Partial resection of the ileum with end-to-end anastomosis and enterostomy was performed. The patient underwent peritoneal dranage, because it was difficult to determine the viability of the subserosal wall of the intestine. Postoperatively HSP had often attacked the patiet. Medical treatment were inieffective, but oral administration of diaminodipphenyl sulfone (DDS) which started six months after the operation successfully managed HSP. So 12 months after the operation the patient was reoperated on. Only 5 cm of stenotic and drain portion had to be resected. The authers recommend simple dranage and a staged opration for perforations in patients with HSP.
