Acute Gastrointestinal and Genito-urinary Manifestations in Children with Henoch-Schönlein Purpura

Purpose: To review the incidence and management of acute gastrointestinal and genito-urinary manifestations in children with Henoch-Schonlein purpura (HSP). Methods: The records of children admitted with HSP in recent 10 years were reviewed. Results: 165 children were admitted with HSP. Seventy children, aged 2-17 years, had acute surgical manifestations, 42 of which presented before the onset of purpura or arthralgia. Gastrointestinal symptoms included abdominal pain (61), per-rectal bleeding (9), prolonged ileus with ascites (1) and haematemasis (1). Genitourinary symptoms included acute scrotum (9) and frank haematuria (2). Abdominal sonography was performed in 14 patients, scrotal sonography in two boys. None required operative intervention. Twenty-seven children required systemic steroid. Conclusions: Acute gastrointestinal and genito-urinary manifestations are common in children with HSP and frequently precede purpura and arthralgia. Vigilant physical examination and judicious sonography enable correct diagnosis. Conservative management almost invariably suffices and systemic steroid is useful in selected cases.