Wang T, Wang C, Zhou KY, Wang XQ, Hu N, Hua YM. Incomplete Kawasaki disease complicated with acute abdomen: A case report. World J Clin Cases 2020; 8(21): 5457-5466 [PMID: 33269284 DOI: 10.12998/wjcc.v8.i21.5457]
Corresponding Author of This Article
Yi-Min Hua, MD, Doctor, Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20 3rd Section, South Renmin Road, Chengdu 610041, Sichuan Province, China. yimin.hua19@yandex.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2020; 8(21): 5457-5466 Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5457
Incomplete Kawasaki disease complicated with acute abdomen: A case report
Tao Wang, Chuan Wang, Kai-Yu Zhou, Xiao-Qin Wang, Na Hu, Yi-Min Hua
Tao Wang, Chuan Wang, Kai-Yu Zhou, Xiao-Qin Wang, Yi-Min Hua, Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Tao Wang, Chuan Wang, Kai-Yu Zhou, Xiao-Qin Wang, Yi-Min Hua, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610065, Sichuan Province, China
Tao Wang, Chuan Wang, Kai-Yu Zhou, Xiao-Qin Wang, Yi-Min Hua, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu 610041, Sichuan Province, China
Na Hu, Department of Medical Imaging, West China Hospital/West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wang T was responsible for the study design and manuscript preparation; Wang C contributed to intellectual content and manuscript editing; Zhou KY was responsible for the literature research and manuscript review; Wang XQ was responsible for the study concepts; Hu N was responsible for the clinical studies; Li FL contributed to data acquisition; Hua YM was responsible for guaranteeing the integrity of the entire study; All authors read and approved the final manuscript.
Supported byScience and Technology Program of Sichuan, No. 2019YFS0239.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interests.
CARE Checklist (2016) statement: The article was revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Min Hua, MD, Doctor, Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, No. 20 3rd Section, South Renmin Road, Chengdu 610041, Sichuan Province, China. yimin.hua19@yandex.com
Received: June 3, 2020 Peer-review started: June 27, 2020 First decision: June 13, 2020 Revised: September 4, 2020 Accepted: September 28, 2020 Article in press: September 28, 2020 Published online: November 6, 2020 Processing time: 156 Days and 6.6 Hours
Abstract
BACKGROUND
Kawasaki disease (KD) is an acute systemic vasculitis characterized by unknown etiology.
CASE SUMMARY
A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD. He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy. Ultrasound examination at early onset revealed a giant coronary artery aneurysm. The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest. He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery. After the operation, the cardiac output increased, and the symptoms of heart failure resolved. Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure, and normal growth was obtained.
CONCLUSION
Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm . Nevertheless, some issues still need specific attention.
Core Tip: Large-scale epidemiologic investigations and studies with long-term follow-up about coronary artery bypass graft in patients with Kawasaki disease have been rarely reported. At present, anastomosis of the left internal mammary artery with left anterior descending coronary artery is considered to be the optimal bypass grafting technique, as it yields satisfactory long-term patency and survival rates.
