BACKGROUND Kawasaki disease (KD) is an acute febrile multisystem vasculitis and has been recognized to be the most common cause of acquired heart disease in children. Owing to its propensity to involve vessels throughout the entire body, KD often mimics other disease processes. The diagnosis might be delayed if other prominent symptoms appear before the characteristic clinical features of KD. Although gastrointestinal symptoms including vomiting, diarrhea, and abdominal pain are not uncommon in KD patients, KD with gastrointestinal bleeding is quite rare. CASE PRESENTATION A previously healthy 4-year-old boy initially presented with abdominal pain, followed by fever, rash, and gastrointestinal hemorrhage, eventually diagnosed as complete KD. The patient recovered smoothly after appropriate management and no subsequent complications occurred in the following months. CONCLUSION The diagnosis of KD should be considered in children presenting with abdominal symptoms and fever without definable cause. Pediatricians should be aware of the risk of gastrointestinal bleeding in patients with KD, especially in those with prominent abdominal symptoms.

中文翻译：

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川崎病抗凝治疗前胃肠道出血：一例报告。

背景技术川崎病（KD）是一种急性发热性多系统血管炎，已被认为是儿童获得性心脏病的最常见原因。由于KD倾向于使血管遍布全身，因此KD经常模仿其他疾病过程。如果在KD的特征性临床特征之前出现其他明显症状，则诊断可能会延迟。尽管在KD患者中胃肠道症状（包括呕吐，腹泻和腹痛）并不罕见，但伴有胃肠道出血的KD很少见。病例介绍先前健康的4岁男孩最初表现为腹痛，随后出现发烧，皮疹和胃肠道出血，最终被诊断为完全性KD。适当治疗后，患者恢复平稳，随后几个月未发生任何并发症。结论对于有腹部症状和发烧而无明确原因的儿童，应考虑KD的诊断。儿科医师应意识到KD患者（尤其是腹部症状突出的患者）发生胃肠道出血的风险。