Schnlein Henoch Purpura

Schönlein-Henoch syndrome or anaphylactoid purpura, is a vasculitic disease of unknown origin, although is has been suggested to be a viral-induced, allergic, or hypersensitive reaction. Schönlein-Henoch syndrome most commonly occurs in children under 10 years old. It may involve the small blood vessels of the skin, joints, gut and/or kidney. More than 50% of cases have abdominal symptoms, which may precede the cutaneous rash and cause a diagnostic dilemma (Hayden 1996). Sonographi-cally, several degrees of localized or diffuse involvement can be demonstrated in the small bowel loops. Most commonly, there is symmetrical transmural thickening of the bowel wall, secondary to sub-mucosal edema and hemorrhage (Hayden 1996)

Fig. 1.73a-c. Crohn's disease. A 14-year-old boy with several previous episodes of abdominal pain. a,b Longitudinal US scans at the terminal ileum and ileocecal valve (arrows) showing diffuse wall thickened. Mural stratification is preserved. The submucosa (S) is enlarged. c Longitudinal US scan shows marked wall thickening of the ascending colon

Fig. 1.73a-c. Crohn's disease. A 14-year-old boy with several previous episodes of abdominal pain. a,b Longitudinal US scans at the terminal ileum and ileocecal valve (arrows) showing diffuse wall thickened. Mural stratification is preserved. The submucosa (S) is enlarged. c Longitudinal US scan shows marked wall thickening of the ascending colon b a c

(Fig. 1.74). Luminal narrowing and ascites may be significant. Some transient small bowel intussusceptions can be observed. Schonlein-Henoch syndrome, in general, is a self-limited process with a very good clinical outcome.

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