ABSTRACT
An acute, febrile, self-limited disease process occurred in an otherwise healthy young adult that satisfies accepted criteria for the diagnosis of Kawasaki disease. Unusual features of this case include the patient's age and the documentation of notable, acute noncalculous distention of the gallbladder, a recognized complication of the condition. Evidence of cystic-duct obstruction during the acute phase of distention and subsequent establishment of patency during the convalescent stage is provided with the use of serial ultrasonographic and radioisotopic studies. Discussion of the possible mechanisms for acute hydrops of the gallbladder in Kawasaki disease is included and the need to consider this diagnosis in young adults with the appropriate clinical manifestations is underscored.
Subject(s)
Edema/complications , Gallbladder Diseases/complications , Lymphatic Diseases/complications , Mucocutaneous Lymph Node Syndrome/complications , Acute Disease , Adult , Age Factors , Cholestasis, Extrahepatic/complications , Cystic Duct/diagnostic imaging , Humans , Liver/diagnostic imaging , Male , Mucocutaneous Lymph Node Syndrome/diagnosis , Radionuclide Imaging , UltrasonographyABSTRACT
Blunt trauma to the abdomen is the main cause of pancreatic injury in childhood. One of the most common causes of injury is child abuse. Pancreatitis, pancreatic pseudocyst, and loculated peripancreatic effusion are sequellae of this trauma. The diagnosis of these lesions is aided by ultrasound. Pancreatic injury in children may require different methods of management than it does in adults. Persistently elevated serum amylase levels and increasing cyst size are indications for surgical intervention. However, the natural history of a pseudocyst in an otherwise normal child may lead to spontaneous resolution. In this report, three cases of pancreatic pseudocyst caused by child abuse are presented. In two of the patients, the cysts underwent spontaneous resolution.
