Endoscopy 2001; 33(9): 811-813
DOI: 10.1055/s-2001-16529
Case Report
© Georg Thieme Verlag Stuttgart · New York

Life-Threatening Gastrointestinal Bleeding due to a Jejunal Lesion of Henoch-Schönlein Purpura

F. Lippl 1 , W. Huber 1 , M. Werner 2 , H. Nekarda 3 , H. Berger 4 , N. Weigert 1
  • 1 Dept. of Internal Medicine II, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
  • 2 Dept. of Pathology, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
  • 3 Dept. of Surgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
  • 4 Dept. of Interventional Radiology, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
Further Information

Publication History

Publication Date:
20 August 2001 (online)

The case of a 56-year-old patient with Henoch-Schönlein purpura (HSP) and fulminant gastrointestinal bleeding is reported. The patient was admitted to hospital because of palpable purpura on both legs, painful joints and diffuse abdominal pain. Suspected HSP was histologically proven and treated with prednisolone. Despite recovery, acute gastrointestinal bleeding, with melena and a drop in hemoglobin concentration from 11.2 to 4.2 g/dl, occurred 30 days after medication was started. Immediate endoscopic examination of the upper gastrointestinal tract showed no signs of bleeding whereas colonoscopy showed fresh blood and blood clots in the terminal ileum and the colon. Since the bleeding source could not be detected endoscopically, mesenteric angiography was performed, demonstrating active bleeding from a jejunal artery. Thereafter the bleeding source was located by intraoperative peroral enteroscopy and treated by resection of a short segment of jejunum.

References

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F. Lippl,M.D. 

Dept. of Internal Medicine II
Klinikum rechts der Isar
Technical University of Munich

Ismaninger Strasse 22
81675 Munich
Germany


Fax: + 49-89-41406161

Email: florian.lippl@lrz.tum.de