The gastrointestinal manifestations of Henoch-Schonlein purpura (HSP) are well characterised, but their recognition can be difficult when they occur in isolation. Furthermore, HSP can run a more serious course in adults, compared to children, in whom the disease usually occurs.We describe two cases that illustrate the challenges of HSP with mesenteric vasculitis and the outcome in adults.Although self-limiting in most patients, the outcome of HSP in adults can be far from benign and even fatal.