The gastrointestinal manifestations of Henoch-Schönlein purpura are diverse and, in the absence of the diagnostic rash, can easily be confused with other conditions. The case presented below illustrates the capacity of this entity to masquerade as acute appendicitis and as acute Crohn disease.
Report of a Case.—A 6-year-old boy had a four-day history of periumbilical pain and vomiting. He had had an upper-respiratory tract infection the week prior to development of symptoms, and a temperature of 38.3 C (101 F) orally on the day prior to presentation. He had no history of diarrhea, hematochezia, trauma, or urinary tract symptoms, nor did he have a past history of weight loss, unexplained fevers, or substantial abdominal pain.
Physical examination disclosed an enervated boy with decreased moisture of his buccal mucosa, normal skin turgor, a soft but diffusely tender abdomen with voluntary guarding in all four quadrants, bilateral rebound tenderness greater on