Henoch-Schonlein purpura is a common pediatric disease presenting most frequently with skin, gastrointestinal, joint and renal manifestations. But in cases are infrequently only severe gastrointestinal manifestations. It is hard to diagnose promptly and exactly. Clinical manifestations and laboratory findings were observed and analyzed in 20 cases with Henoch-Schonlein purpura which were considered as acute abdomen, hospitalized at Kyung Hee university Hospital during the period from December, 1982 to September, 1992. The following results were obtained; 1) The age distribution of Henoch-Schonlein purpura had a peak incidence between 7 to 9 year old. And male preponderance was observed with male to female ratio of 2.33 to 1. 2) The most prevalent season for the initial presentation of Henoch-Schonlein purpura was in fall: in 10 cases (50%). 3) The frequency of each type of clinical manifestations showed 20 (100%), 20 (100%), 18 (90%), 8(40%) cases for skin, gastrointestinal, joint and renal manifestation respectively in order of frequency. 4) The common previous illness were URI, 40 cases (50%) and allergy, 2 cases (10%). 5) The onset time of skin manifestation from admission were 1 to 4 days (75%0, 5 to 8 days (15%), 9 to 12 days (10%) explolaparotomies were done the last 2 cases. 6) In all cases, X-ray study (100%), abdominal sono (50%), Meckels scan and colon study (5%) respectively were done. 7) Hematologically leukocytosis over 10,000/mm3 was observed in 80% of cases and increase in ESR over 20 mm/hr in 65% of cases. Coagulation studies, immunologic and complement level revealed the result within normal range in most of the cases. 8) Among 8 cases with renal involvement, all cases had both hematuria and proteinuria. 9) Most cases were recovered within 4 weeks but in 4 cases, renal biopsies were done because of relapse. The results were Meadow classification grade I (1 case), II (1 case), IVa (2 cases). After renal biopsy, steroid pulse therapy was started.
Abdomen, Acute* ; Age Distribution ; Biopsy ; Child ; Classification ; Colon ; Complement System Proteins ; Female ; Hematuria ; Humans ; Hypersensitivity ; Incidence ; Joints ; Leukocytosis ; Male ; Proteinuria ; Purpura, Schoenlein-Henoch* ; Recurrence ; Reference Values ; Seasons ; Skin ; Skin Manifestations

PURPOSE: Stomach cancer is the most prevalent extracolonic malignancy of the many primary cancers that occur together with colorectal cancer in Koreans. The purpose of this study was to evaluate the characteristics of patients who present with double primary cancer of the stomach and colorectum. METHODS: From Sep. 1994 to Dec. 2004, in 4,305 patients were diagnosed with colorectal cancer. Among these patients, 51 patients were diagnosed synchronously or metachronously as also having stomach cancer. The mean age these patients was 60.8 years and the median follow up duration was 31.0 months. RESULTS: The incidence of double primary cancer of the stomach and colorectum was 1.2% of the total colorecal cancer patients and they were 0.6% of the total stomach cancer patients. There were 17 (33.3%) metachronous cases and 34 (66.7%) synchronous cases. For the metachronous cases, the mean interval was 15 months (12~98) and detection methods were postoperative CT, symptom of second a cancer, and routine endoscopic examination. In synchronous cases, second cancer was detected by routine endoscopic examination, preoperative radiologic evaluation, and intraoperative exploration. Intraoperatively the detected cancers were all colorectal cancer during the operation for stomach cancer. The stage of the colorectal cancer was higher than that of the stomach cancer in 30 cases. Local or systemic recurrences were seen in 9 cases (17.6%), and 7 cases were recurrence of colorectal cancer. The 5-year disease free survival rates was 55.8%. CONCLUSION: The incidence of cancer arising from colorectum and stomach has been reported to be increasing. Careful attention should always be paid to the possible presence of a second cancer in preoperative or postoperative evaluation of cancer patients.
Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Neoplasms, Second Primary ; Recurrence ; Stomach Neoplasms ; Stomach*