兒童Henoch-Schoulein紫斑症之腸胃道表微及消化道內視鏡所見

Gastrointestinal Manifestations and Endoscopic Findings in Children with Henoch-Schonlein Purpura

丁綺文(Chi-Wen Ting) ； 吳子聰(Tzee-Chung Wu) ； 鄭經和(Jin-Her Cheng) ； 黃碧桃(Betau Hwang)

《Acta Paediatrica Sinica》 29卷5期 (1988/10) Pp. 303-308

摘要

Henoch-Schonlein紫斑症為一種原因不明的全身性血管炎，常侵犯腸胃道。本文就100例患童的消化道表微作分析，發現病程中具腸胃症狀之比例高達81%，以腹痛最常見(77%)，其次為腸道出血(42%)，其它症狀包括嘔吐、肝臟腫大、肝功能異常及血清澱粉酶升高等。其中18例接受上消化道內視鏡及7例同時接受下消化道內視鏡檢查，發現食道(16.7%)、胃部(72.2%)、十二指腸(72.2%)、及乙狀結腸(57.1%)有黏膜充血、點狀出血、糜爛等變化。過半數(55.5%)病童可看到本病典型的出血糜爛性十二指腸炎影像。由於本研究對象中有22%的病例係以腸胃表微爲最初症狀，且發生於皮膚疹出現之前，不易被診斷，回顧其住院臆斷往往爲腹部急症或消化道出血。對於此類病例，若能配合內視鏡的特徵性病灶，將可提供診斷之助益，迅速給予治療，減少不必要的開刀及併發症。

並列摘要

One hundred patients with Henoch-Schonlein purpura are reported. Gastrointestinal tract was involved in 81% of cases. Twenty-two percent of patients presented the gastrointestinal symptoms and signs as the initial manifestation. Symptoms including abdominal manifestation. Symptoms including abdominal pain (77%) and bleeding from gastrointestinal tract (42%) were common. Minor symptoms and signs included vomiting, hepatomegaly, abnormal liver function test and elevated serum amylase. Gastrointestinal endoscopy was studied in 18 cases. The characteristic lesions of mucosal petechia and hemorrhagic erosive duodenitis are described. These findings may lead the pediatrician and gastroenterologists to aware the possibility of using endoscopy as a valuable diagnostic tool in this disease.

並列關鍵字

Henoch-Schonlein purpura ； Gastrointestinal endoscopy ； Children