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Pneumatosis intestinalis and intestinal perforation in a case of multisystem inflammatory syndrome in children

Lela Heza1, Aliza Olive2, Jenna Miller3

  • 1Medical School, Kansas City University, Kansas City, MO, USA.

BMJ Case Reports
|April 23, 2021
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) can cause severe abdominal issues, including pneumatosis intestinalis and bowel perforation, in children. Close monitoring for gastrointestinal complications is crucial for critically ill pediatric patients with MIS-C.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Critical Care Medicine
  • Pediatric Infectious Diseases

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a serious condition affecting multiple organs.
  • Gastrointestinal symptoms are common in MIS-C, but severe surgical complications are rare.
  • Pneumatosis intestinalis and bowel perforation are critical surgical emergencies.

Observation:

  • A pediatric patient with MIS-C presented with fever, abdominal pain, and shortness of breath.
  • The patient developed hemodynamic instability and pneumatosis intestinalis.
  • Small bowel perforation was confirmed approximately one week after admission.

Findings:

  • This case highlights a rare but severe gastrointestinal complication of MIS-C.
  • Pneumatosis intestinalis and small bowel perforation occurred in a pediatric patient with MIS-C.
  • The patient's condition progressed to hemodynamic failure.

Implications:

  • Pediatric patients with MIS-C require vigilant monitoring for abdominal catastrophes.
  • Early recognition and surgical consultation are vital for children with MIS-C and abdominal pain.
  • Intensive care unit (ICU) management should include a low threshold for investigating severe abdominal pathology in MIS-C patients.

Keywords:
COVID-19paediatric surgery

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