Intussusception Associated with Necrosis and Perforation After Henochschönlein Purpura

Aim: We aimed to evaluate surgical procedure carried out to an 8 years old child, clinically diagnosed as Henoch-Schönlein Purpura (HSP), undergoing intussusception repair, because of allergic vasculitis, erythamatose maculopapuler rashes, rectal bleeding, abdominal pain and intussusception, under the light of literature data. Case Report: An eight years old and a male child was consultated because of his biliary vomiting, nausea and diffuse maculopapuler rushes which were localised especially in lower extremites. The symptoms of HSP were observed at histopathologic examination of skin. On examination, the symptoms of acute abdomen, which were characterised with diffuse tenderness and distansion, hipoactive intestinal sounds and abondant biliary drainage from nasogastric tube, were identified. The pneumatic and hydrostatic reductions were not performed because of the risk of perforation due to severe peritonitis and his poor general condition. The patient was operated on after preoperative resuscitation. During the explorative laparatomy, edema and the symptoms of insufficient vascularisation in all intestinum were present. Also, it was observed that approximately 20 cm’s intestinal segment which begins from 10 cm proximal of ileocaecal valve, had been necrotic and ileostomy was carried out after resecting this segment. Meanwhile, it was observed that the whole intestine was edematous and localised blood circulation was distorted in some areas. The patient was operated on to make bridectomy when evisceration and brid ileus occurred on postoperative eleventh day, and the ileostomy was closed at the same session. The patient was delivered with complete recovery 16 days after closing of ileostomy. Conclusion: Although HSP is rarely seen as the cause of acute abdomen, too serious complications of this disease must be kept in mind.