cases

The child shown in the photograph attends casualty 

complaining of the rash and severe abdominal pain.

 What would be the appropriate response? Select ONE answer only

 A) Reassure and discharge home

 B) Prescribe laxatives

 C) Discharge with regular analgesics

 D) Prescribe a course of oral steroids

 E) Arrange an abdominal ultrasound scan

Correct answer is E- Arrange an abdominal ultrasound scan. The photo shows a purpuric rash on the lower limbs and some inflammation of the ankles. This is due to HSP.Although the abdominal pain may result from mesenteric vasculitis, patients with HSP are at increased risk of developing intussusception. An abdominal ultrasound scan will help to exclude this. Once intussusception has been excluded, the abdominal pain may be managed by simple analgesics. Refractory cases may benefit from a short course of oral steroids