Twenty-two patients with Henoch-Schonlein syndrome are reviewed, and four unusual cases are reported in detail. Henoch-Schonlein syndrome represents a diagnostic prolem when abdominal manifestations precede cutaneous lesions and suggest a surgical abdomen. Unusual radiographic features such as changes in the small bowel identical to Crohn disease or colonic involvement may further obscure the diagnosis. Intussusception and rarely bowel obstruction may complicate the clinical course. The spectrum of clinical and radiographic findings is described to increase the awareness of the radiologist to the possibility of the diagnosis of Henoch-Schonlein syndrome.