[Hypersensitivity vasculitis causing an acute abdomen].

Abstract

The members of a family of four persons suffered acute gastroenteritis after eating a meal consisting of chicken. While three of them recovered rapidly, the 18-year old son developed an acute abdomen which had to be treated surgically and led to a complicated stay at the intensive care unit. Intraoperatively, a mild insignificantly inflamed appendix and an obscure segmental inflammatory process of the small bowel with local peritonitis were seen; this required an appendectomy and a peritoneal lavage. The development of bacterial peritonitis with multiple organ dysfunction required several surgical revisions with an open abdominal toilet treatment. Histological examination of the resected appendix specimen showed a severe primary fibrinoid necrotizing vasculitis with epitheloid-granulomatous reaction. Diseases such as Panenteritis nodosa, Wegener's disease and Churg-Strauss's syndrome were excluded by negative serology. By a process of exclusion, a hypersensitivity vasculitis was diagnosed and treated successfully with a high-dose cortisone regime.

• Authors: S Hanelt, J Karner, P Peichl, W Hackl, M Klimpfinger
• Journal: Wiener klinische Wochenschrift (Wien Klin Wochenschr) Vol. 111 Issue 6 Pg. 226-9 (Mar 26 1999) ISSN: 0043-5325 [Print] Austria
• Vernacular Title: Hypersensitivitätsvaskulitis als Ursache eines akuten Abdomens.
• PMID: 10234776 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Cortisone

Topics

• Abdomen, Acute (drug therapy, etiology, surgery)
• Adolescent
• Appendicitis (surgery)
• Appendix (pathology, surgery)
• Churg-Strauss Syndrome (diagnosis)
• Cortisone (therapeutic use)
• Diagnosis, Differential
• Gastroenteritis (surgery)
• Humans
• Intraoperative Complications
• Male
• Peritonitis (microbiology, surgery)
• Vasculitis, Leukocytoclastic, Cutaneous (complications, diagnosis, drug therapy)