Surgical complications in children with IgA vasculitis: clinical analysis of 28 cases.
Complicaciones quirúrgicas en niños con vasculitis IgA: análisis clínico de 28 casos.
Abstract
Intussusception and intestinal perforation are surgical severe complications in children with IgA vasculitis (IgAV). Early diagnosis and timely appropriate surgical intervention can reduce damage to the children. We analyzed retrospectively the clinical characteristics, auxiliary examinations, diagnosis, treatment, and prognosis of 28 children with IgAV accompanied by surgical complications (including intussusception in 21 patients and intestinal perforation in seven patients) who were admitted to the Beijing Children’s Hospital of the Capital Medical University from May 2016 to December 2020. Within one year after the data was collected, the parents of the children were interviewed by telephone about their treatment. Increased peripheral leukocytes were observed in 60.7% of children. Serum C-reactive protein (CRP) and D-dimer were elevated in 53.3% and 75% of children, respectively. Gastrointestinal bleeding was identified in 39% of children. Of the children with intussusception, the symptoms subsided spontaneously in four children and after air enema in another four. Four children underwent laparotomy and manual reduction. Nine patients underwent enterectomy and anastomosis. Enterectomy and anastomosis were performed in the seven patients with intestinal perforation, two of whom underwent enterostomy concurrently. Increased inflammation indexes, elevated D-dimer, and persistent abdominal pain without relief may be risk factors for surgical complications in children with IgAV.
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