Henoch-Schonlein Purpura

Henoch-Schonlein is a type of hypersensitivity vasculitis and inflammatory response within the blood

Fig. 5.27. A boy with cystic fibrosis complicated with distal intestinal obstruction syndrome. Note the dilated intestinal loops and huge fecal impaction in the terminal ileum and caecum

vessel. It is caused by an abnormal response of the immune system. The syndrome is usually seen in children and is more common in boys (Parker 2003).

Clinical symptoms are purple spots on the skin, joint pain, gastrointestinal symptoms and glomer-ulonephritis. Gastrointestinal symptoms include abdominal pain, nausea, vomiting, diarrhea and bloody stools. Bleeding into the bowel wall occurs in about half of patients and may act as a lead point for intussusception.

Routine abdominal radiographs (Fig. 5.29a) give no significant information and are not recommended, unless perforation is clinically suspected.

Ultrasound is the imaging modality of choice and will show thickened bowel wall, ascites, ileus of affected loops, bowel dilatation and possible entero-enteric intussusceptions (Fig. 5.29b) (ConnoLLY and O'HALpin 1994).

Fig. 5.28. Intestinal tuberculosis. CT scan shows the heterogenic, hypodense masses with peripheral ringlike calcifications following lymphadenitis and ascites

Fig. 5.29. a Supine abdominal film of a child with Henoch-Schonlein. Note the intestinal wall thickening on plain film. b-d A patient with Henoch-Schonlein disease. The thickened wall is demonstrated by ultrasound d b

Fig. 5.29. a Supine abdominal film of a child with Henoch-Schonlein. Note the intestinal wall thickening on plain film. b-d A patient with Henoch-Schonlein disease. The thickened wall is demonstrated by ultrasound b


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