Adv Pediatr Surg.  2018 Dec;24(2):107-112. 10.13029/aps.2018.24.2.107.

Prolonged Gallbladder Hydrops in a Kawasaki Disease Patient

• Yoon KL
• Kim DH
• Han MY
• Cha SH
• Kim HC

• KMID: 2429808
• DOI: http://doi.org/10.13029/aps.2018.24.2.107

Abstract

Although gallbladder (GB) hydrops in childhood is uncommon, it is most commonly associated with Kawasaki disease (KD) and can be a risk factor of poor outcomes in patients with KD. Our patient presented with a fever, diffuse abdominal pain, maculopapular rash, bilateral conjunctivitis, red and fissured lip tissue, and 3 days of right cervical swelling. Abdominal examination revealed abdominal distension and tenderness. Abdominal ultrasonography was performed to identify the source of abdominal symptoms, which revealed dilatation of the GB. Abdominal computed tomography scan was also performed to exclude other hepatobiliary disease, which showed normal hepatobiliary systems. The GB of our patients returned to a normal size without any complications, but it regressed very slowly. We report a case of a 6-year-old boy with KD who presented with markedly distended and unusually prolonged GB hydrops.

Keyword

Gallbladder disease; Kawasaki disease; Children

MeSH Terms

Abdominal Pain
Child
Conjunctivitis
Dilatation
Edema*
Exanthema
Fever
Gallbladder Diseases
Gallbladder*
Humans
Lip
Male
Mucocutaneous Lymph Node Syndrome*
Risk Factors
Ultrasonography

Figure

• 

  Fig. 1 Abdominal radiograph supine view (A) and erect view (B) indicated modest shadowing of gallbladder distension.

• 

  Fig. 2 Echocardiography showed severe gallbladder distension (A) 8.9×4.6 cm in size and (B) 10.2×5.5 cm in size.

• 

  Fig. 3 Abdominal ultrasonography showed severe gallbladder distension (A) 9.8×4.9 cm in size and (B) 9.3×4.3 cm in size.

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  Fig. 4 Abdominal computed tomography (A, B) performed at 10 days after fever onset showed marked distended gallbladder (8.0×5.5 cm in size) without wall thickening or sludge, which is consistent with gallbladder hydrops.

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  Fig. 5 Abdominal ultrasonography (A) performed at 23 days after fever onset revealed a slow regression of the gallbladder hydrops (6.7×3.2 cm in size). Echocardiography (B) performed at 81 days after fever onset revealed a complete improvement in gallbladder hydrops and a normal gallbladder.

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