Davies M, Nanda Kumar M, Shetty V, Mitchell P
Lancashire Teaching Hospitals NHS Foundation Trust , UK.
Ann R Coll Surg Engl. 2017 Feb;99(2):e88-e90. doi: 10.1308/rcsann.2016.0359. Epub 2017 Jan 4.
A 52-year-old man presented with a purpuric rash affecting his legs and hypertension. He was diagnosed with Henoch-Schönlein purpura and discharged with non-steroidal anti-inflammatory drugs. Three weeks later, he presented again with loss of appetite and vomiting before developing abdominal pain with pyrexia of 38.5°C and rigors. On examination, he was hypotensive with a distended abdomen and a national early warning score of 6. Computed tomography revealed enteropathy of Henoch-Schönlein purpura. The patient deteriorated and went for an emergency laparotomy, where 30cm of ischaemic small bowel was resected.
一名52岁男性出现累及双下肢的紫癜性皮疹及高血压。他被诊断为过敏性紫癜,出院时带了非甾体类抗炎药。三周后,他再次就诊,出现食欲不振和呕吐,随后出现腹痛,体温达38.5°C且伴有寒战。检查时,他血压低,腹部膨隆,国家早期预警评分6分。计算机断层扫描显示过敏性紫癜性肠病。患者病情恶化,接受了急诊剖腹探查术,术中切除了30厘米缺血性小肠。