chemamr
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How do you treat an invagination in a kid with henoch schonlein purpura ??? is it treated in the same way that a pt without this purpura ??
This is a doubt I have, I donīt know the answer. 
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| merrk
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hey chemamr, what do mean by an invagination??? and what is the treatment in a kid w/o HSP?
Thanks!
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| chemamr
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invagination = intussusception.
tx in a kid w/o HSP is a reduction with water soluble enema or pneumatic reduction.
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| merrk
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I thought so... but didnt know it was also referred to as invagination. Do you know why it happens in HSP?
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| chemamr
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not really merrk. Hey, your test is near. Good luck friend !!, mine is in 2 weeks 
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| phuluong2k
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In HSP, a small hematoma in bowel will cause intussusception
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| chemamr
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thank you phuluong2k. You have an excellent base in basic sciencies, i have noted that. That will help you. 
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| merrk
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thanks chemamr! good luck to you too!
Found this interesting article:
Surg Today. 2002;32(12):1031-4. Related Articles, Links
Conservative treatment for small intestinal intussusception associated with Henoch-Schonlein's purpura.
Sonmez K, Turkyilmaz Z, Demirogullari B, Karabulut R, Aral YZ, Konus O, Basaklar AC, Kale N.
Department of Pediatric Surgery, Gazi Medical Faculty, Gazi University, 46. Sokak 28/3, Bahcelievler, 06510 Ankara, Turkey.
PURPOSE: Emergency laparotomy is generally considered the appropriate course of action for small bowel intussusception associated with Henoch-Schonlein's purpura (HSP). In this paper, we define a conservative approach after witnessing spontaneous reduction of ileoileal invagination at laparotomy in a patient with HSP who had been on steroid therapy for renal involvement. METHODS: HSP was diagnosed by the appearance of a purpuric rash without thrombocytopenia. Intussusception was diagnosed by ultrasonography (USG) and plain abdominographs, which showed signs of obstruction, and clinical examination. Barium enema was used to treat ileocolic intussusceptions, and conservative therapy, consisting of nasogastric drainage, steroids, and intravenous fluid administration, was used to treat ileoileal intussusceptions. Emergency laparotomy was performed for the patients unresponsive to therapy within 24 h, those with peritonitis, and those with ileocolic invagination not able to be reduced by barium enema. RESULTS: Six children with an ileoileal intussusception and one with an ileocecal intussusception were studied. The average age was 6 years old. Apart from the initial patient in whom spontaneous reduction was seen at laparotomy, three others required emergency laparotomy; for ileocolic intussusception unable to be reduced by barium enema in one, for ileoileal invagination with peritonitis on admission in one, and for ileoileal intussusception unresponsive to conservative therapy in one. The other three patients were successfully treated by conservative therapy. CONCLUSION: Conservative therapy is feasible for HSP patients with small bowel intussusception as long as the time of onset is known, an ultrasonographic and X-ray diagnosis is confirmed, emergency operating facilities are available, and an experienced pediatric surgical team follows up the patients.
PMID: 12541018 [PubMed - indexed for MEDLINE]
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| chemamr
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good work merrrk!!
itīs good. So, basically itīs treated in the same way, conservative and if fails, then go for surgery.
All right
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