Perforation of the Bowel in Henoch-schonlein Purpura
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چکیده
Case 1. D.J.S., a 4i-year-old boy, was admitted to the medical wards of Alder Hey Children's Hospital with a diagnosis of Henoch-Schonlein purpura. On the tenth day the child showed signs of intestinal obstruction and a mass was palpable in the right iliac fossa. He was transferred to the surgical wards with a diagnosis of intussusception. At operation an ileo-ileal intussusception was reduced with some difficulty. The bowel was viable but there was some subserosal haemorrhage. The immediate post-operative period was very satisfactory, but, on the fifth post-operative day, the patient suddenly collapsed and on examination had signs of generalized peritonitis. After adequate intravenous therapy he was taken to the theatre. At the second operation, on opening the peritoneal cavity, gas and faecal material were encountered. Two inches of the ileum were gangrenous and numerous large perforations were found in the healthy segment of gut, one foot proximal to the intussuscepted area. Resection of the gangrenous segment was carried out and the two ends of the bowel were exteriorized, as the condition of the patient did not permit an anastomosis. Postoperatively he was critically ill and died four days later.
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