The anaesthetic management of a case of Kawasaki's disease (mucocutaneous lymph node syndrome) and Beckwith-Weidemann syndrome presenting with a bleeding tongue.
An unusual case of a 13-month-old child with Kawasaki's disease and the Beckwith-Weidemann syndrome is presented. The child, while anticoagulated with warfarin and aspirin to prevent extension of a coronary artery thrombus, fell and lacerated the tongue resulting in haemorrhage and significant swelling. The ongoing haemorrhage, combined with difficulty in securing venous access resulted in the child becoming shocked. Surgical intervention was required to stem the haemorrhage. The anaesthetic management of a shocked child with a coronary artery aneurysm and thrombosis, a potentially difficult airway and a full stomach is described.
Thomas
M L
ML
Department of Anaesthesia, Great Ormond Street Hospital for Sick Children NHS Trust, London, UK.
McEwan
A
A
D000058:Accidental Falls; D000769:Anesthesia, Inhalation; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001506:Beckwith-Wiedemann Syndrome / Q000150:complications*; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008260:Macroglossia / Q000150:complications*; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D006472:Oral Hemorrhage / Q000209:etiology / Q000601:surgery*; D012769:Shock / Q000209:etiology; D014059:Tongue / Q000293:injuries*
D000925:Anticoagulants