Surgical complications of Kawasaki disease

The surgical manifestations of the intestinal tract in Kawasaki disease

“…The laboratory findings may be hyperbilirubinemia, elevated transaminases [22], and positive guaiac test. Surgical manifestations are much less frequent and include small bowel obstruction and strictures [13], intussusception [19], ischemic colitis [12], perforation of duodenum [17], hemorrhagic enteritis [23], appendicitis [18], pancreatitis [9], and hydrops of gallbladder [6]. The typical pathology of the small intestine shows degeneration, necrosis, and desquamation of the epithelial cells, as well as inflammatory exudates in the lamina propria and in the muscular layer [24].…”

Early but Prolonged Gallbladder Hydrops in a 7-Month-Old Girl with Kawasaki Syndrome: Report of a Case

“…The cardiovascular involvement in KS is the major determinant for mortality. 7 In conclusion, gallbladder hydrops associated with KS may manifest in infants as young as 7 months old.…”

“…5 Moreover, gallbladder hydrops is a nonspecifi c reactive serositis, exacerbated by factors such as fever, ileus, prolonged fasting, and dehydration, with consequent bile stasis. 6,7 In KS, gallbladder hyrops is related to nonspecifi c vasculitis. 8 The abdominal crises occurring with KS manifest as abdominal pain (100%), right upper quadrant tenderness (90%), vomiting (75%), and a palpable mass (55%).…”

Intestinal Pseudoobstruction in Kawasaki Disease

“…11 Surgical complications in KD are well recognized. Complications reported in the literature include bowel infarction, 12 bowel obstruction related to ischemic strictures, [13][14][15][16] focal colitis, 17 and peripheral gangrene. 12,13,18,19 Intestinal pseudoobstruction has been reported to occur in up to 2% to 3% of children with KD.…”

“…Complications reported in the literature include bowel infarction, 12 bowel obstruction related to ischemic strictures, [13][14][15][16] focal colitis, 17 and peripheral gangrene. 12,13,18,19 Intestinal pseudoobstruction has been reported to occur in up to 2% to 3% of children with KD. 20,21 A clue to the development of this complication, as demonstrated in the present case, is the presence of persistent vomiting during the course of the illness, which is uncommon in KD.…”