RESUMEN
Kawasaki disease (KD) is an acute, febrile, vasculitis of mainly large to medium-sized vessels. KD is a self-limited illness of infancy and childhood and 80% of the patients are younger than four years of age with an incidence of 5.6/100,000 in the United States. We present an unusual case of an 18-year-old man with several unique features of KD. He was admitted to the hospital with fever, rash, and arthralgia for one week. KD was among the differentials for fever, rash, and arthralgia. Later all the laboratory diagnosis for bacterial and viral infections including blood and urine culture came out negative and he was further evaluated for KD with electrocardiography (EKG), echocardiography, and angiography which showed myocarditis. Based on typical features of fever, rash, arthralgia, bilateral conjunctival injection, cervical lymphadenopathy, and prominent tongue papillae he was diagnosed with KD.
RESUMEN
Biloma is an encapsulated collection of bile outside or inside the biliary system within the abdominal cavity. It is a rare condition with an incidence of 0.3%-2%. The most common cause of spontaneous biloma is choledocholithiasis, and other causes include abdominal trauma and surgery, bile duct tumors, liver infarction, percutaneous catheter drainage, transhepatic cholangiogram and endoscopic retrograde cholangiopancreatography (ERCP) but the exact cause is yet to be discovered. We herein present a case report of biloma as a complication of laparoscopic cholecystectomy. A 58-year-old male presented to our hospital emergency room with complaints of fever, nausea, vomiting, and pain in the right upper quadrant after six weeks of laparoscopic cholecystectomy for cholecystitis. He was diagnosed with computed tomography (CT) scan quickly, and he has treated with pigtail catheter percutaneous drainage. On a follow-up visit, after four weeks, his abdominal pain had improved and white blood count was also reduced to baseline.