Abdominal anaphylactoid purpura of 10 cases of misdiagnosis.docVIP

 PAGE \* MERGEFORMAT 5 Abdominal anaphylactoid purpura of 10 cases of misdiagnosis [Keywords:] purpura, abdominal / diagnosis, misdiagnosis Henoch-Schonlein purpura (HSP is more common in children in a small vessel allergic inflammatory response, clinical manifestations of skin petechia, ecchymosis, joint swelling, pain, abdominal symptoms and renal damage [1]. Led to gastrointestinal symptoms development or major performance, easy to misdiagnosis, often misdiagnosed as acute gastroenteritis, mesenteric lymphadenitis, severe abdominal pain often misdiagnosed as gastrointestinal perforation, acute appendicitis, intestinal obstruction, and even lead to surgical exploration. our department from 2004 to 2009 A total of 10 patients with gastrointestinal symptoms as the first of the HSP patients were misdiagnosed early, is analysis as follows. 1 Clinical data The patients were 6 males and 4 females, aged 4 to 10 years old, misdiagnosed for 3 to 6 days. Misdiagnosed as 5 cases of mesenteric lymphadenitis, acute appendicitis in 2 cases, 3 cases of acute gastroenteritis. 2 typical cases Example 1, male, aged 5, 2 days because of intermittent abdominal pain, increased with nausea, vomiting 1 day, at home to “acute gastroenteritis” poor effect of oral medications to clinic. Checkup: T 37 4 , pharynx Department of congestion, abdominal soft, light Cullen tenderness, bowel sounds normal existence. Cullen abdominal ultrasound showed enlarged lymph nodes (1 6 cm 1 7 cm, blood WBC 11 0 109 / L. Diagnosis of “mesenteric lymphadenitis, acute upper respiratory tract infection “, given anti-inflammatory, antiviral, antispasmodic agents and abdominal physical therapy 3 days, ineffective, severe abdominal pain, pain when crying disturbed, careful examination, found in the left lower leg lateral two purple spots , consider the HSP, given oral prednisone, abdominal pain quickly eased. Example 2, male, 8 years old, fever, abdominal pain, vomiting 2 days for medi