Purpura, abdominal pain and massive ascites

Abstract

Objective To explore the clinical characteristics of Henoch-Schonlein purpura complicated with acute necrotizing acute pancreatitis, in order to provide information for the diagnosis and differentiation of Henoch-Schonlein purpura complicated with acute abdominal disease. Methods There was a case present with purpura, abdominal pain, massive ascites and poor spirit in Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University.The clinical manifestations and physical examination results were summarized and discussed, some pediatric specialists from nephrology department, surgery department, digestive system department were invited to discuss the case.The treatment was adjusted according to result of discussion, the final diagnosis was tracked. Results The case was firstly diagnosed with Henoch-Schonlein purpura, acute diffuse peritonitis with cause in dispute.After the discussion, the intestinal necrosis, perforation could not be excluded, acute pancreatitis required further identification.Exploratory laparotomy was received because of the changing condition after discussion.The intraoperative diagnosis was acute necrotizing pancreatitis.The patient recovered well with medical treatment. Conclusion When children with Henoch-Schonlein purpura had an acute abdominal disease, acute necrotizing pancreatitis should be considered in addition to intestinal necrosis, perforation. Key words: Purpura; Necrotizing pancreatitis; Abdominal pain; Ascites