A case of massive lower gastrointestinal bleeding that develope during treatment of henoch-schönlein purpura

Korean J Med > Volume 72(2); 2007 > Article

Original Article

The Korean Journal of Medicine 2007;72(2):175-180.

A case of massive lower gastrointestinal bleeding that develope during treatment of henoch-schönlein purpura

고려대학교 의과대학 내과학교실

증례 : Henoch-Schönlein purpura 치료 중 발생한 대량 하부 위장관 출혈 1예

강민경

Abstract

Henoch-Schönlein purpura (HSP) is characterized by the classic tetrad of purpura, arthralgia, abdominal pain, and renal involvement. It is common in childhood, but may also occur in adults and can be accompanied by severe complications. Gastrointestinal (GI) bleeding is one type complication and if it occurs, usually develops during an active inflammatory stage. We experienced a case of 45 year-old man with Henoch-Schönlein purpura who showed massive GI bleeding during steroid treatment. At the first visit of the patient, an upper GI endoscopy and colonoscopy revealed severe hemorrhagic ulcers in the duodenum and terminal ileum. After treatment with high dose corticosteroid, the lesions improved. However, at 21 days after the first visit, hematochezia developed and angiography showed active bleeding at the ileocolic branch of the superior mesenteric artery. Successful hemostasis was performed with embolization. One must consider that delayed GI bleeding may occur during improvement of the initial GI lesions in an HSP patient.(Korean J Med 72:S175-S180, 2007) Key Words : Purpura, Henoch Schönlein, Gastrointestinal Hemorrhage

Key Words: Purpura, Henoch Schönlein, Gastrointestinal Hemorrhage