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Novel Coronavirus Infection in an Infant with Intussusception
Juan Felipe Osorno1,2, Manuel Giraldo1,2, Andrés Felipe Marín1,2
1Hospital Universitario del Valle-Evaristo García, Cali, Colombia.
Insights
Intussusception, a common cause of intestinal obstruction in infants, can be associated with COVID-19. This case highlights the potential link between SARS-CoV-2 infection and intussusception in children, emphasizing gastrointestinal symptoms as key indicators.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Intussusception is the primary cause of intestinal obstruction in children under four.
- Viral infections are common triggers, with SARS-CoV-2 being a suspected cause.
- Only five cases of co-occurring intussusception and COVID-19 have been documented globally.
Observation:
- An 8-month-old infant presented with fever, bloody diarrhea, abdominal pain, and signs of peritonitis.
- Ultrasound confirmed intussusception, leading to surgical intervention.
- Intraoperative findings revealed transverse colon intussusception, peritonitis, and intestinal ischemia.
Findings:
- The patient underwent intestinal resection with ileostomy and mucous fistula.
- SARS-CoV-2 infection was confirmed via RT-PCR.
- Postoperative recovery included pediatric intensive care, enteral feeding, and respiratory support.
Implications:
- Gastrointestinal symptoms in children can be primary manifestations of COVID-19.
- COVID-19 may present with or causally relate to conditions like intussusception.
- Early recognition and management are crucial for pediatric patients with combined COVID-19 and intussusception.
Abstract:
Background. Intussusception is the leading cause of intestinal obstruction in children under 4 years of age. Viral infections are the associated etiology in most cases, SARS-CoV-2 thereby being a plausible cause, although only 5 cases have been reported worldwide with both entities. We report a case of an infant with Intussusception and covid-19, its clinical approach, and surgical outcomes, throughout a retrospective review of electronic medical chart history with the authorization of the Ethics Committee on research of the "Hospital Universitario del Valle" and endorsement for publication. Case report. It is an 8-month-old male patient with 72 hours of fever 100.4°F; bloody diarrheal stools; episodic abdominal pain; signs of peritoneal irritation and sensation of a mass in the right quadrants of the abdomen. Intussusception confirmed by ultrasound led to surgery, with SARS-CoV-2 infection as a possible differential diagnosis. Surgical findings reported intussusception of the transverse colon, peritonitis, and intestinal ischemia of distal ileum and right colon, for which intestinal resection with consequent ileostomy and a mucous fistula was performed. Positive SARS-CoV-2 RT-PCR test result was confirmed. Pediatric intensive care unit support took place at the initial postoperative phase, and eventual intestinal, with enteral feeding tolerance at the fourth day, and respiratory improvement came off within the first week of medical and surgical treatment. Conclusion. Gastrointestinal symptoms are often the leading manifestations of COVID-19 in children, which can be isolated or as a common sign of a concomitant pathology such as intussusception, and they could also have a causal relationship.
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