Abstract
Abdominal complaints are a frequent early feature of Kawasaki disease, an acute systemic febrile vasculitis of childhood. The only well known correlating morphological finding on abdominal US is gallbladder hydrops. We report two boys with Kawasaki disease who showed segmental thickening of the small-bowel wall on abdominal US. These changes are thought to result from bowel-wall oedema due to vasculitis of the supplying vessels. We conclude that in an acutely ill febrile child with the finding of segmental bowel-wall thickening on abdominal US, Kawasaki disease should be considered in the differential diagnosis. The search for gallbladder hydrops and segmental bowel-wall thickening on abdominal US may serve as an important diagnostic tool in Kawasaki disease, supporting early recognition and prompt treatment.
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References
Kawasaki T (1967) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi 16:178–222
Magilavy DB, Speert DP, Silcer TM et al (1978) Mucocutaneous lymph node syndrome: report of two cases complicated by gallbladder hydrops and diagnosed by ultrasound. Pediatrics 61:699–702
Curtis N, Levin M (1998) Kawasaki disease thirty years on. Curr Opin Pediatr 10:24–33
Park AH, Batchra N, Rowley A et al (1997) Patterns of Kawasaki syndrome presentation. Int J Pediatr Otorhinolaryngol 40:41–50
Chung CJ, Rayder S, Meyers W et al (1996) Kawasaki disease presenting as focal colitis. Pediatr Radiol 26:455–457
Yaniv L, Jaffe M, Shaoul R (2005) The surgical manifestations of the intestinal tract in Kawasaki disease. J Pediatr Surg 40:e1–e4
Franken EA Jr, Kleiman MB, Norins AL et al (1979) Intestinal pseudo-obstruction in mucocutaneous lymph-node syndrome. Radiology 130:649–651
Miyake T, Kawamori J, Yoshida T et al (1987) Small bowel pseudo-obstruction in Kawasaki disease. Pediatr Radiol 17:383–386
Akikusa JD, Laxer RM, Friedman JN (2004) Intestinal pseudoobstruction in Kawasaki disease. Pediatrics 113:e504–e506
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Maurer, K., Unsinn, K.M., Waltner-Romen, M. et al. Segmental bowel-wall thickening on abdominal ultrasonography: an additional diagnostic sign in Kawasaki disease. Pediatr Radiol 38, 1013–1016 (2008). https://doi.org/10.1007/s00247-008-0900-3
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DOI: https://doi.org/10.1007/s00247-008-0900-3