Document Detail

Multiple intestinal stenoses and peripheral gangrene: a combination of two rare surgical complications in a child with Kawasaki disease.
MedLine Citation:
PMID:  11283900     Owner:  NLM     Status:  MEDLINE    
Kawasaki disease (KD) often presents with a challenging variety of clinical symptoms. Severe gastrointestinal complications are rare and mainly appear as pseudo-obstruction. However, the authors report the unique case of a 4-month-old girl with KD suffering from a mechanical ileus. The optimal timing of surgery presented a dilemma, because she received lytic treatment for gangrenes of both her hands and feet and additionally had large coronary artery aneurysms. Finally laparotomy had to be performed while the patient was on an anticoagulant medication, and it showed a 30-cm-long jejunal segment with multiple filiforme stenoses, requiring resection and anastomosis. The postoperative course was uneventful regarding the abdominal situation; however, the left hand and left foot remained gangrenous and had to be amputated. In patients with KD, not only pseudo-obstruction, but irreversible intestinal obliteration has to be encountered. This combination of intestinal stenosis and acral gangrene has not been described before. J Pediatr Surg 36:651-653.
C Krohn; H Till; S Haraida; K Kurnik; R Boehm; R Grantzow; I Joppich
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  36     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-03     Completed Date:  2001-09-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  651-3     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company.
Department of Pediatric Surgery, University of Munich, Lindwurmstr. 4, D-80337 Munich, Germany.
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MeSH Terms
Follow-Up Studies
Foot / pathology*
Gangrene / diagnosis,  etiology,  surgery
Hand / pathology*
Intestinal Obstruction / diagnosis,  etiology,  surgery*,  therapy*
Jejunal Diseases / diagnosis,  etiology,  therapy*
Laparotomy / methods
Mucocutaneous Lymph Node Syndrome / complications*,  therapy*
Risk Assessment
Severity of Illness Index

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