1/2. Emergency surgery and refractory immune thrombocytopenic purpura. A case report.A 35-year-old woman with post-splenectomy refractory immune thrombocytopenia presented with an acute abdominal emergency requiring laparotomy. Her platelet count was raised from 10 to 96 X 10(9)/l using a combination of high-dose methylprednisolone, plasma exchange against fresh-frozen plasma, infusion of gammaglobulin and a single mega-unit of platelets. The surgical procedure was uneventful, and with no further therapy the platelet count rose to a peak of 244 X 10(9)/l, but over the following 7 days fell back slowly to 10 X 10(9)/l, at which time the patient was discharged well.- - - - - - - - - - ranking = 1keywords = purpura (Clic here for more details about this article) |
2/2. A case of vasculitic cholecystitis associated with Schonlein-Henoch purpura in an adult.A case of Schonlein-Henoch purpura (SHP) in a 32 year-old female, showing gastrointestinal manifestations including acute vasculitic cholecystitis was reported. In the course of hospitalization urgent laparotomy was performed because of the severe abdominal pain. The gallbladder was inflamed with a brownish-red edematous wall and subserosal hemorrhage, and was resected. Histological examination of the resected gallbladder specimen revealed leucocytoclastic vasculitis. The patient was treated with prednisolone postoperatively, and symptoms abated over two weeks. Acute cholecystitis with SHP is extremely rare, and as far as the authors know this is the second case of this disorder documented by histological examination. patients with acute abdomen associated with SHP should be managed with consideration of the complications of acute cholecystitis.- - - - - - - - - - ranking = 1keywords = purpura (Clic here for more details about this article) |