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Abdominal US in Pediatric Inflammatory Multisystem Syndrome Associated with SARS-CoV-2 (PIMS-TS)
Riwa Meshaka1, Fern C Whittam1, Myriam Guessoum1
1From the Department of Imaging, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, England (R.M., F.C.W., M.G., S.E., K.M., M.P.H., P.D.H., A.D.C., M.J.E., E.P.G., T.W.); NIHR Great Ormond Street Hospital Biomedical Research Centre, London, England (S.C.S., O.J.A.); and University College London Hospital, London, England (P.D.H.).
Pediatric inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS) can cause abdominal issues. Ultrasound findings of bowel inflammation and mesenteric edema in children with PIMS-TS typically resolve within two months.
Area of Science:
- Pediatric Radiology
- Pediatric Infectious Diseases
- Gastroenterology
Background:
- Pediatric inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS), also known as multisystem inflammatory syndrome in children, presents with nonspecific symptoms including abdominal pain.
- While initial imaging features of PIMS-TS have been documented, the duration of these sonographic findings is not well-established.
Purpose of the Study:
- To characterize the abdominal ultrasound (US) features of PIMS-TS at the time of initial presentation.
- To assess the resolution of these US findings during follow-up examinations.
Main Methods:
- A retrospective review was conducted on children and young adults with suspected PIMS-TS from April 2020 to June 2021.
- Abdominal US features were documented at initial presentation and follow-up. Descriptive statistics and interobserver variability were calculated.
Main Results:
- Of 102 patients with PIMS-TS who underwent abdominal US, 84% showed abnormalities, most commonly ascites (64%).
- Bowel wall thickening was observed in 14% and mesenteric inflammation in 16% of patients, all presenting with abdominal symptoms.
- Follow-up US indicated that bowel inflammation resolved in 11% within 2 months and in 0% after 2 months, with all US abnormalities resolving by 2 months.
Conclusions:
- Abdominal US findings, including bowel inflammation and mesenteric edema, are present in a significant proportion of children with PIMS-TS.
- These sonographic abnormalities associated with PIMS-TS demonstrate a clear resolution, typically within a two-month period.
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