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Spontaneous resolution of intussusception after COVID-19 infection found at laparoscopy in a 6-year-old
Renato Díaz-Ruiz1,2, Paula Ponce-de-León-Lovatón3, Paulo Delgado-Seminario1
1Hospital III Jose Cayetano Heredia, EsSalud, Piura, Peru.
Insights
Intussusception is rare in schoolchildren, but this case highlights a potential link to COVID-19 infection. Early diagnosis is crucial for favorable outcomes in pediatric gastrointestinal emergencies.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Public Health
Background:
- Intussusception commonly affects infants, with peak incidence between 4-10 months.
- Previous reports link intussusception to acute COVID-19 in infants, including cases of MIS-C.
- No prior cases of intussusception associated with COVID-19 in schoolchildren have been documented.
Observation:
- A 6-year-old male presented with symptoms including fever, headache, abdominal pain, and vomiting.
- Initial SARS-CoV-2 testing was negative, but serology indicated past infection.
- Abdominal ultrasound revealed intussusception, confirmed by exploratory laparoscopy.
Findings:
- This case represents the first reported instance of intussusception in a school-aged child following COVID-19 infection.
- While 13 cases of intussusception linked to acute COVID-19 exist in younger children, this highlights a potential association in older children.
- The patient recovered favorably after surgical intervention.
Implications:
- Gastrointestinal symptoms in children warrant consideration of both active and past SARS-CoV-2 infection.
- Abdominal ultrasound should be considered for diagnosing intussusception in children presenting with relevant symptoms.
- Further research is needed to understand the potential link between COVID-19 and intussusception in school-aged populations.
Abstract:
The incidence of intussusception is 2.5 per 1000 live births, and infants between 4 and 10 months of age represent the highest frequency peak. Cases of intussusception with acute COVID-19 infection have been reported in infants under one year of age and with one death associated with MIS-C. However, we have not found reports of intussusception in schoolchildren. We report the case of a 6-year-old male with two days of illness that began with a sensation of temperature rise, headache, abdominal pain, liquid stools with mucus and no blood, hyporexia, chills, and food vomiting. He presented a negative result for the detection of SARS-CoV-2 antigen, negative SARS-CoV-2 IgM/IgG serology positive (lateral flow immunochromatography test), in addition to total IgM/IgG antibodies in 11.88 COI by means of a test of electrochemiluminescence. An abdominal ultrasound was performed that concluded invagination, for which an exploratory laparoscopy was performed and the patient evolved favorably. 13 cases of intussusception associated with acute COVID-19 infection have been described in this group. However, no reports of intussusception have been described after COVID-19 infection in school age. We recommend ruling out active or past SARS-CoV-2 infection in children with gastrointestinal symptoms and, if it exists, ruling out invagination by means of abdominal ultrasound.
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