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Gallbladder hydrops in mucocutaneous lymph node syndrome
1Combined Medicine/Pediatric Residency Program, William Beaumont Army Medical Center, El Paso, TX 79920-5001.
Insights
Mucocutaneous lymph node syndrome (MLNS) can cause acute gallbladder hydrops. Patients with this combination are typically older, and diagnosis involves abdominal symptoms, liver tests, and ultrasound confirmation.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Cardiology
- Diagnostic Imaging
Background:
- Mucocutaneous lymph node syndrome (MLNS), also known as Kawasaki disease, is an acute febrile illness.
- Gallbladder hydrops is a rare complication of MLNS.
Observation:
- A case of acute gallbladder hydrops in a 36-month-old boy with MLNS is presented.
- A review of 46 cases revealed that patients with MLNS and gallbladder hydrops are older than those without gallbladder hydrops.
Findings:
- Abdominal symptoms and abnormal liver function tests suggest the diagnosis.
- Ultrasonography confirms gallbladder enlargement (twice normal size).
- Increased risk of cardiac complications is noted.
Implications:
- Early diagnosis and recognition of this association are crucial.
- Supportive care is primary treatment; cholecystostomy is indicated for operative intervention.
- Understanding this association may improve patient outcomes and management strategies.
Abstract:
A 36-month-old boy had acute gallbladder hydrops in association with mucocutaneous lymph node syndrome. A review of 46 other cases of this association has shown that patients having MLNS with gallbladder hydrops are older than those without gallbladder hydrops. The diagnosis is suggested by abdominal symptoms and abnormal results of liver function tests. The diagnosis is confirmed by ultrasonography, which shows the gallbladder to be twice the normal size. Cardiac complications may be increased. Treatment is largely supportive, but cholecystostomy is the procedure of choice in cases requiring operative intervention.