Medical education Snapshot
Digestive system diseases Ophthalmology Health occupations Dermatology
Volume 216 - Issue 9

Periorbital purpura following intense emesis

Authors:  Yi‐Teng Hung and Chun‐Bing Chen

Med J Aust 2022; 216 (9): 454-454. || doi: 10.5694/mja2.51504
Published online: 16 May 2022

A 6-year-old girl presented with a 24-hour history of sudden onset, non-tender periorbital rash

Download PDF (569 KB)
Share: Share on Blue Sky Share on Facebook Share on LinkedIn Share by email


A 6‐year‐old girl presented with a 24‐hour history of sudden onset, non‐tender periorbital rash. There was no history of trauma or insect bite. At the time of onset, she had acute gastroenteritis associated with several episodes of intense vomiting. On examination, well demarcated, non‐blanchable and pinpoint‐sized petechiae were noted bilaterally in the periorbital area (Figure). The mechanism of periorbital purpura is dermal capillary rupture in the loose connective tissues of the eyelids due to elevated intravascular pressure after Valsalva manoeuvre or any severe straining,1,2 in this case as a result of intense emesis. The rash self‐resolved after 4days following relief of vomiting. The differential diagnoses of periorbital purpura include intracranial aetiologies (eg, dural sinus thrombosis and superior sagittal sinus thrombosis), extracranial aetiologies (eg, vomiting, coughing and sneezing), disorders affecting orbital vasculature (eg, systemic amyloidosis and Kaposi sarcoma), trauma (eg, skull base fracture), and coagulopathies or bleeding disorders.1

 

Authors

  • Yi‐Teng Hung1,2
  • Chun‐Bing Chen1,2,3
  • 1. Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
  • 2. Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
  • 3. Chang Gung University, Taoyuan, Taiwan

Correspondence: chunbing.chen@gmail.com

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library

More like this

Digestive system diseases Research 18 August 2026 Open Access

Early-Onset Colorectal Cancer With Liver-Only Metastases: A Retrospective Cohort Study Integrating Prospectively Collected Real-World Clinical and Molecular Data From an Australian National Database (2009–2024) to Guide Treatment Planning

Savio G. Barreto, Christos S. Karapetis, Shahid Ullah, Matthew Burge, Susan Caird, Angus Campbell, Azim Jalali, Ross Jennens, Muhammad A. Khattak, Belinda Lee, Stephanie H. Lim, Shehara Mendis, Louise Nott, Timothy J. Price, Jeremy D. Shapiro, Jeanne Tie, Javier Torres, Colin Williams, Rachel Wong, Vanessa Wong, Peter Gibbs

Digestive system diseases Guideline summary 20 October 2025 Open Access

Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations

Jacob George, Nicole L Allard, Stuart K Roberts, Leon A Adams, Jane Davies, Behzad Hajarizadeh, Jennifer H MacLachlan, Suzanne E Mahady, Rosalie Altus, Catherine Brown, David C Fry, Belinda Greenwood‐Smith, Natali Smud, Patricia C Valery, Nafisa Yussf, Kate Broun, Denise Campbell, Karen Canfell, Chelsea Carle Harrison, Victoria Freeman, Paul Grogan, Catherine Holliday, Suzanne Hughes, Anna Kelly, Cathelijne Kemenade, Claire Latumahina, Amanda McAtamney, Megan Varlow, Joachim Worthington, Susan Yuill, Eleonora Feletto

View more