The Clinical Diagnosis And Treatment Of Children With Henoch-schonlein Purpura Combining Of Intussusception

Objective: To analyze children diagnosed Henoch-Schonlein purpura with intussusception admitted to Children's Hospital of Chongqing Medical University.Methods: Collecting clinical date of children with Henoch-Schonlein purpura with intussusception from 2006.01 to 2016.12,including general information,clinical manifestation,imaging examination and treatment.Results: A total of 45 cases were collected including 30 male children,15 female children,male: female is 2:1,the age of children was from 1 years an 1month to 16 years and 3months,and the average age was 8 years and7 months.45 cases manifested as skin purpura and abdominal pain(100%),35 cases manifested as vomiting(89%),cases manifested as bloody stools(58%),fever(29%),abdominal mass(24.4%).35 cases appeared skin purpura firstly,2 cases appeared skin purpura and abdominal symptoms at the same time,8 cases of children appeared abdominal symptoms came firstly.All the children took ultrasonography and had the sign of “concentric circles sign” and” False kidney sign”.The Hedge position included : Hepatic flexure 27 cases(60%),Right lower abdomen 7 cases(15%),Right middle abdomen6 cases(13%),Left lower abdomen 2 cases(5%),splenic flexure of colon 2 cases(5%),Pelvic cavity 1 case(2%).6 children underwent surgical treatment directly,39 cases firstly received air enema,only 16 cases(41%)succeeded,23 cases(59%)failed and underwent surgical treatment,with Ileocolic intussusception in 20 cases,Ileoileal intussusception in 7cases,Ileoileocolic intussusception in 1case,Jejunojejunal intussusception in 1case.And 10 cases received enterectomy,the average distance was 29±15cm,and 19 cases received manual reduction,the distance of children received enterectomy was 13 ±6 cm,and P < 0.001.Conclusion: Children with Henoch-Schonlein purpura with intussusception mostly occurred in School-age children,and boys were more than girls.Common clinical manifestations were skin purpura,allergic purpura abdominal pain,vomiting,bloody stools,fever and abdominal mass,air enema success rate was lower,and enterectomy rate was higher.