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COVID-19-Related Intestinal Ischemia in A 7-Year Old Boy

Balázs Fadgyas1, Gábor István Garai1, János Schnur2

  • 1Department of Surgery and Traumatology, Heim Pál National Institute of Paediatrics, Budapest, Hungary.

European Journal of Pediatric Surgery Reports
|August 22, 2022
PubMed

Insights

Pediatric multisystem inflammatory syndrome (PIMS) can cause severe abdominal issues. This case highlights COVID-19-related intestinal ischemia and Meckel's diverticulitis requiring surgical intervention.

Area of Science:

  • Pediatric surgery
  • Infectious diseases
  • Pediatric critical care

Background:

  • Pediatric multisystem inflammatory syndrome (PIMS) often presents with severe abdominal pain and vomiting.
  • Early pandemic reports focused on medical management for suspected surgical abdomen in PIMS, discouraging surgical exploration.
  • Limited data exists on COVID-19-associated surgical complications like intestinal ischemia in children.

Observation:

  • A non-immunocompromised child with PIMS presented with symptoms suggestive of acute surgical abdomen.
  • The child developed intestinal ischemia complicated by Meckel's diverticulitis.
  • Surgical intervention was deemed necessary despite initial hesitations due to COVID-19 concerns.

Findings:

  • This case demonstrates a severe outcome of COVID-19-related vasculitis contributing to intestinal ischemia and Meckel's diverticulitis in a child.
  • Vasculitis and hypotension episodes likely played a role in the ischemic event.
  • Surgical intervention was successfully performed, indicating its potential necessity in select PIMS cases.

Implications:

  • Highlights the need for careful surgical evaluation in children with PIMS presenting with abdominal emergencies.
  • Suggests that COVID-19-related vasculitis can lead to severe gastrointestinal complications requiring surgical management.
  • Emphasizes that a proactive surgical approach may be critical for specific PIMS-associated abdominal conditions.

Keywords:
COVID-19Meckel's diverticulitischildhypotensionpediatric multisystem inflammatory syndromeintestinal ischemia

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