Gastrointestinal Presentation at Onset or After Initial Treatment in Kawasaki Disease

Kawasaki disease (KD) is an acute febrile illness that was recognized as the most common acquired cardiovascular disease among children. Recent years have witnessed a progressive increase in the proportion of cases diagnosed with incomplete KD owing to atypical clinical presentation. The typical reported gastrointestinal symptoms in these patients include diarrhea, vomiting, abdominal pain, hepatitis, gallbladder hydrops, and pancreatitis. This study reviewed 4 patients with KD at our hospital, who presented with acute abdomen. The presence of atypical symptoms such as gastrointestinal symptoms tends to obviate the other manifestations of KD, which may lead to misdiagnosis of acute abdomen and inappropriate surgical treatment. As illustrated in this case series, these children have clinical symptoms or signs suggestive of KD (especially lymphadenopathy or rash) early in the disease course that are liable to be missed or overlooked.