Abstract: This paper reports the diagnosis and treatment of a 17-year-old male patient with idiopathic thrombocytopenic purpura complicated with acute gangrenous appendicitis.The patient was admitted for metastatic right lower abdominal pain with a platelet count of only 3×10⁹/L.Emergency preoperative preparation such as intravenous immunoglobulin infusion was given followed by appendectomy.Postoperatively,eltrombopag and thrombopoietin were combined for platelet elevation.During hospitalization,the white blood cell count and neutrophil ratio showed a continuous downward trend,while the platelet count rose rapidly from 3×10⁹/L to 530×10⁹/L at discharge.Inflammatory markers returned to normal and the patient was discharged successfully.This case suggests that such comorbidities are life-threatening.Rapid platelet elevation with intravenous immunoglobulin during the perioperative period and delicate vascular ligation during surgery are the key to treatment,and continuous platelet elevation and abdominal bleeding monitoring are needed postoperatively.

Key words: idiopathic thrombocytopenia, acute gangrenous appendicitis, intravenous immunoglobulin infusion