Kumon Y, Hisatake K, Chikamori M, Hara H, Numata Y, Yamano T, Ohno F
Second Department of Internal Medicine, Kochi Medical School, Nankoku, Japan.
Gastroenterol Jpn. 1988 Feb;23(1):68-72. doi: 10.1007/BF02918859.
A case of Schönlein-Henoch Purpura (SHP) in a 32 year-old female, showing gastrointestinal manifestations including acute vasculitic cholecystitis was reported. In the course of hospitalization urgent laparotomy was performed because of the severe abdominal pain. The gallbladder was inflamed with a brownish-red edematous wall and subserosal hemorrhage, and was resected. Histological examination of the resected gallbladder specimen revealed leucocytoclastic vasculitis. The patient was treated with prednisolone postoperatively, and symptoms abated over two weeks. Acute cholecystitis with SHP is extremely rare, and as far as the authors know this is the second case of this disorder documented by histological examination. Patients with acute abdomen associated with SHP should be managed with consideration of the complications of acute cholecystitis.
报告了一例32岁女性的过敏性紫癜(SHP),表现为包括急性血管炎性胆囊炎在内的胃肠道表现。住院期间,由于严重腹痛进行了紧急剖腹手术。胆囊发炎,壁呈棕红色水肿,浆膜下出血,遂行胆囊切除术。切除的胆囊标本组织学检查显示白细胞破碎性血管炎。患者术后接受泼尼松龙治疗,症状在两周内缓解。急性胆囊炎合并过敏性紫癜极为罕见,据作者所知,这是第二例经组织学检查证实的该疾病病例。伴有过敏性紫癜的急腹症患者应考虑急性胆囊炎的并发症进行处理。