〔Abstract〕 Objective The clinical features of children with abdominal type Henoch-Schönlein purpura(HSP) and the changes of gastrointestinal mucosa under endoscopy were analyzed, and the relationship between them was further discussed. Methods The clinical manifestations and endoscopy characteristics of 116 children with abdominal type HSP were analyzed retrospectively, according to the degree of mucosal damage under endoscopy, the children were divided into two groups. The disease course, the symptom score of purpura, the rate of acute pancreatitis and the rate of Henoch-Schönlein purpura nephritis(HSPN) were compared, and the high risk factors of severe mucosal damage in children with HSP were analyzed. The difference of the degree of mucosal damage under endoscopy between the two groups with digestive tract as the first symptom and rash as the first symptom was analyzed. Results ① Abdominal HSP often manifeste as abdominal pain, vomiting, haematemesis, melena and hematochezia, while under endoscopy, it was characterized by purplish red mucous rash with different degrees,of density slightly higher than the surface of mucous membrane, and could be distributed in flakes, and the appearance of interrash mucosa could be normal, which was similar to that of skin purpura. ② There was no significant difference in symptom score and acute pancreatitis complications between the two groups(P>0.05). ③ The total time of recombinant abdominal pain, the time of complete relief of abdominal pain after admission, the length of hospitalization and the incidence of HSPN during hospitalization were significantly higher than those in mild mucosal lesion group(P<0.05). ④ The increase of serum CRP was an independent risk factor for severe mucosal damage in children with abdominal HSP, and its level was positively correlated with the degree of gastrointestinal mucosal injury in children with HSP. ⑤ The damage of mucous membrane in HSP children with digestive tract as the first symptom was more serious than those with rash under endoscopy(P<0.05). Conclusion Endoscopy can be used for early diagnosis of HSP with abdominal pain as the first symptom.The increase of serum CRP in abdominal HSP can be used as an index to predict the degree of gastrointestinal damage. Serious injury of digestive tract mucosa may be a risk factor for renal damage in children with HSP.