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Hydrops of the gallbladder associated with Kawasaki syndrome
E A Suddleson1, B Reid, M M Woolley
1Department of Surgery, Childrens Hospital of Los Angeles, CA.
Insights
Hydrops of the gallbladder in Kawasaki syndrome is a common abdominal crisis in children. Nonoperative management with close monitoring is a safe and effective treatment, avoiding surgery in most cases.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Cardiology
- Pediatric Surgery
Background:
- Hydrops of the gallbladder is a significant complication in children with Kawasaki syndrome.
- It is recognized as a major component of the abdominal crisis associated with this condition.
Purpose of the Study:
- To evaluate the safety and efficacy of nonoperative management for hydrops of the gallbladder in Kawasaki syndrome.
- To present clinical and pathological data from a series of patients.
- To review existing literature on the diagnosis and treatment of this condition.
Main Methods:
- Retrospective review of 16 pediatric patients diagnosed with hydrops of the gallbladder secondary to Kawasaki syndrome.
- Analysis of treatment outcomes, including surgical (cholecystectomy) and nonoperative management.
- Review of 41 reported cases from English language literature.
Main Results:
- Fifteen out of sixteen patients were successfully managed nonoperatively with serial ultrasonic evaluation and clinical monitoring.
- One patient required cholecystectomy.
- No significant adverse events were reported in the nonoperatively managed group.
Conclusions:
- Nonoperative management is a safe and effective treatment strategy for hydrops of the gallbladder in Kawasaki syndrome.
- Close clinical monitoring and serial ultrasonography are crucial for successful nonoperative treatment.
- Surgical intervention may be avoided in the majority of pediatric cases.
Abstract:
Hydrops of the gallbladder is recognized as a major component of the abdominal crisis occurring in children with Kawasaki syndrome. Sixteen patients with hydrops of the gallbladder secondary to Kawasaki syndrome have been diagnosed and treated at the Childrens Hospital of Los Angeles. One patient was treated by cholecystectomy and 15 nonoperatively without untoward sequelae. Nonoperative management with serial ultrasonic evaluation and close clinical monitoring is a safe method of treatment for this entity. Pathologic and clinical data are presented and discussed. Review of diagnosis and treatment of 41 reported cases of hydrops of the gallbladder in Kawasaki syndrome from the English language literature is also presented.