2018, Number 4
Complicated acute appendicitis secondary to Henoch-Schönlein in adulthood: An uncommon pathology. A case report
Amarante LGD, Garza CAA, Gamboa ACM, Garmendia CG, Alanís RÓC
Full text
Language: Spanish
References: 14
Page: 171-175
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ABSTRACT
Introduction: Henoch-Schönlein is a self-limited autoimmune disease. It is the most frequent cause of vasculitis in the pediatric age. The presentation in adulthood is a rare occurrence, with a calculated incidence of 3.4 to 14.4 cases per million. It usually disappears spontaneously, but in some cases it may present with serious complications that may require surgical management. Acute appendicitis secondary to this disease is a rarely observed complication. Case report: A 56 years female, without a history of relevance, which began 10 days previous, presenting with abdominal colic type pain in mesogastrium, which subsequently migrated to both iliac crests, accompanied by arthralgias and exanthemathic lesions not itchy on both lower limbs. Physical examination showed data of peritoneal irritation at the lower abdomen. The CT showed abscesses in the pelvic cavity and right iliac fossa. She was schedule for a laparoscopic appendectomy, finding a large abscess in right iliac fossa and others between the intestinal loops. The appendix was perforated at its base and detached from the cecum with necrosis and gangrene. Partial cecum resection and abscess drainage were performed without complications. Once the abdominal sepsis was resolved, histopathological study of the lesions was performed, and in conjunction with results of laboratory studies, Henoch-Schönlein disease was diagnosed. Conclusion: Henoch-Schönlein is a rare disease in adults, abdominal manifestations that are associated with this disease should be diagnosed early because of its high morbidity-mortality when delaying treatment. Although appendicitis secondary to this type of disease is a rare pathology, it is feasible to be treated by laparoscopic appendectomy and should be taken into account for differential diagnosis.REFERENCES
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