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

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

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