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October 1977, Vol 131, No. 10 >
Article | October 1977

Abdominal Mass and Colonic Perforation in a Case of the Hemolytic-Uremic Syndrome FREE

MYRON I. LIEBHABER, MD; BRUCE R. PARKER, MD; JANE A. MORTON, MD; BRUCE M. TUNE, MD
Am J Dis Child. 1977;131(10):1168-1169. doi:10.1001/archpedi.1977.02120230114020.
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Prodromal gastroenteritis seen in the hemolytic-uremic syndrome of childhood is infrequently cause of major problems in the treatment once acute renal failure is established and the diagnosis has been made.1-3 This communication describes a child in whom the development of spontaneous colonic perforation represented a severe, late gastrointestinal complication of the hemolytic-uremic syndrome.

Report of a Case.—A 4½-year-old girl was hospitalized with a one-week history of bloody diarrhea. The child had not urinated 30 hours prior to admission. She was a pale, lethargic, afebrile child, with a firm midline mass extending from the pubis to the umbilicus.

Admission laboratory data included the following values: hemoglobin concentration, 11 gm/100 ml; hematocrit reading, 29%; 1.5% reticulocytes; and 10,000 platelets per cubic millimeter. Peripheral blood smear revealed numerous burr cells and schistocytes. Examination of the bone marrow revealed normal cellularity. A prothrombin time was 13 seconds (control of 11 seconds). Blood

REFERENCES

1 +
Tune B, Leavitt T, Gribble J:  The hemolyticuremic syndrome in California: A review of 28 nonheparinized cases with long-term follow-up . J Pediatr 82:304-310, 1973;.
Link to Article
2 +
Lieberman E:  Hemolytic-uremic syndrome . J Pediatr 80:1-16, 1972;.
Link to Article
3 +
Gianantonio C, Vitacco M, Mendilaharzu F, et al:  The hemolytic-uremic syndrome . J Pediatr 64:478-491, 1964;.
Link to Article
4 +
Berman W:  The hemolytic-uremic syndrome: Initial clinical presentation mimicking ulcerative colitis . J Pediatr 81:275-278, 1972;.
Link to Article
5 +
Bar-Ziv J, Ayoub J, Fletcher B:  Hemolytic Uremic Syndrome: A case presenting with acute colitis . Pediatr Radiol 2:203-205, 1974;.
Link to Article
6 +
Peterson RB, Meseroll, WP, Shrago GG, et al:  Radiographic features of colitis associated with the hemolytic-uremic syndrome . Pediatr Radiol 118:667-671, 1976;.

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References

1 +
Tune B, Leavitt T, Gribble J:  The hemolyticuremic syndrome in California: A review of 28 nonheparinized cases with long-term follow-up . J Pediatr 82:304-310, 1973;.
Link to Article
2 +
Lieberman E:  Hemolytic-uremic syndrome . J Pediatr 80:1-16, 1972;.
Link to Article
3 +
Gianantonio C, Vitacco M, Mendilaharzu F, et al:  The hemolytic-uremic syndrome . J Pediatr 64:478-491, 1964;.
Link to Article
4 +
Berman W:  The hemolytic-uremic syndrome: Initial clinical presentation mimicking ulcerative colitis . J Pediatr 81:275-278, 1972;.
Link to Article
5 +
Bar-Ziv J, Ayoub J, Fletcher B:  Hemolytic Uremic Syndrome: A case presenting with acute colitis . Pediatr Radiol 2:203-205, 1974;.
Link to Article
6 +
Peterson RB, Meseroll, WP, Shrago GG, et al:  Radiographic features of colitis associated with the hemolytic-uremic syndrome . Pediatr Radiol 118:667-671, 1976;.

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