A Case of Duodenal Intramural Hematoma Associated with Henoch - Schonlein Purpura / 대한소화기내시경학회지

ABSTRACT

Henoch-Schonlein purpura is a condition of unknown origin probably related to an autoimmune phenomenon involving an IgA immune complex disorder. Henoch-Schonlein purpura is a rare cause of intramural hematoma of the duodenum. We herein report a case of intramural hematoma of the duodenum and duodenal obstruction associated with Henoch-Schonlein purpura in a 14-yearold boy. On admission, the patient presented with hematemesis due to duodenal ulcer bleeding. Three days later, he developed both forearm and calf purpurae, fever and severe bile juice vomiting. An endoscopy revealed a luminal obstructing erythematous mass with bulging nature at the third portion of the duodenum. Abdominal CT scan and hypotonic duodenography showed intramural hematoma in the third portion of the duodenum and luminal obstruction. Hematoma removal was performed for the correction of intestinal obstruction. Increased awareness of the gastrointestinal manifestations of Henoch-Schonlein purpura should aid in the recognition of this disorder.