Colomo-Padilla AL, Solórzano-Morales SA, Mora-Tizcareño MA, Sorcia-Ramírez G, Garrido-García LM

Language: Spanish
References: 7
Page: 123-128
PDF size: 595.94 Kb.

ABSTRACT

Background: Kawasaki disease is a vasculitis of small and medium size blood vessels, of poorly defined etiology. Today it is the most commoncause of acquired heart disease in Japan and the United States; its incidence in Mexico is unknown. Gallbladder hydrops occurs in 5 to 13% of patients as an atypical manifestation, although the number of cases reported has increased. Its association with perforation is extremely rare.
Clinical case: Boy age seven years in whom symptoms appeared eleven days before hospitalization with high fever which did not improve with drug therapy and abdominal pain in the right upper quadrant; a diagnosis of hepatitis was suspected. An extra-institutional ultrasound showed findings compatible with gallbladder hydrops. On admission to the Instituto Nacional de Pediatría emergency ward he presented fever, abdominal pain, cheilitis, conjunctivitis, photophobia, and conjunctival hyperemia. Another ultrasound was taken evidencing solution of continuity of the wall of the gallbladder fundus communicating with a collection in the hepatorenal recess and the anterior pararenal space, findings corroborated by computed tomography and magnetic resonance. The patient underwent surgery with good evolution and was discharged in good conditions.
Conclusions: The presentation of gallbladder hydrops in Kawasaki disease prior to the appearance of the essential criteria, and its association with perforation, is very rare, for which reason we present this case, to revisit this unusual form of presentation and potential life-threatening complications for the patient.

REFERENCES

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