JHM Young, LTW Chan, KF Huen

Abstract

Typical clinical presentations of Kawasaki disease (KD) are well known to paediatricians. Abdominal pain, vomiting, diarrhoea and hydrops of gallbladder are the commonest gastrointestinal presentations of KD, while acute surgical abdomen or severe gastrointestinal complication as a presenting sign is rare. We report a case of a three-year-old previously healthy boy with KD whose gastrointestinal symptoms and signs were present at the onset, which subsequently progressed to intestinal pseudo-obstruction syndrome, and the condition responded to bowel rest, intravenous immunoglobulin and oral aspirin treatment, without any complications. We suggest that KD should be considered a differential diagnosis of a child presenting with fever and intestinal pseudo-obstruction without identifiable cause, and high index of suspicion of atypical KD should be taken as prompt diagnosis and treatment can prevent serious long term consequences.