Abstract
A case of schonlein-Henoch purpura (SHP) after pancreatoduodenectomy in a 64-year-old woman is reported. The initial symptoms were purpura and arthritis. When abdominal pain occurred first, a thickening of wall of the jejunum which was brought to the porta hepatis through the transverse mesocolon for reconstruction was revealed on abdominal ultrasonography (US). At the second onset of abdominal pain, US revealed a thickening of the intestinal wall covering from the terminal ileum to ascending colon and ascites. With added CT, the whole image of the intestine with thickened wall was able to grasp. A biopsy of skin of the left leg showed numerous neutrophile, nuclear debris, and a small number of acidocytes in the vicinity of vessels ranging from superficial to middle layers of the dermis. The definite diagnosis of SHP was made. The patient was treated with fasting, total parenteral nutrition, and administration of steroid, and symptomatic remission was achieved. The time trends of wall thickening was observed by US, and the thickening decresed with disappearance of abdominal pain and purpura. It is thought that US and CT are useful for diagnosis of SHP with abdominal pain and evaluation of the therapeutic effects.
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