Thrombotic thrombocytopenic purpura presenting as an acute abdomen

✍ Scribed by Dr. M. Elias; Edith Flatau; Y. Bar-El

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 140 KB
• Volume: 72
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800720413

✦ Synopsis

Thrombotic thrombocytopenic purpura (TTP) is a syndrome of unknown aetiology in which disseminated platelet thrombi are formed in capillaries and small arterioles throughout the entire body'*2. Every organ can be involved in this diffuse process, but the relative frequency is different. T h e classical pentad which characterizes TTP is microangiopathic haemolytic anaemia, thrombocytopenic purpura, neurological symptoms, renal disease and f e ~e r ~. ~.

Recently, increased awareness, earlier diagnosis and newer modes of therapy, especially plasma therapy have caused a dramatic increase in the survival rate in TTP. from less than 10 per cent in 19663, t o 50-70 per cent in recent years. Approximately 75 per cent of patients who recover eventually relapse and the mortality rate in such relapses is 50 per cent4.

Abdominal pain appears in 11-14 per cent of the patients, but is usually mild3.4. There is only one report in the literature of acute abdominal pain and paralytic ileus that led t o explorative laparotomy3. We present a young patient with chronic relapsing TTP who presented twice with a dramatic abdominal picture.