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Ileocecal Intussusception in the Era of Coronavirus Disease 2019 (COVID-19) Infection and Multisystem Inflammatory
Niharika Alla1,2, Thaer Abdul-Hadi1, Florentina Litra1,2
1Pediatrics, University of Florida, Pensacola, USA.
Insights
Ileocecal intussusception in children can be triggered by viral infections, including coronavirus disease 2019 (COVID-19). This case highlights the diagnostic challenges of COVID-19 and multisystem inflammatory syndrome in children (MIS-C) presenting with intussusception.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Pediatric Surgery
Background:
- Ileocecal intussusception (ICI) is a critical pediatric surgical emergency, often linked to viral triggers causing mesenteric lymphoid hyperplasia.
- Gastrointestinal (GI) symptoms are recognized in pediatric coronavirus disease 2019 (COVID-19), sometimes as the sole presentation.
- COVID-19 has been implicated as a potential trigger for intussusception in children, both during acute infection and in the context of multisystem inflammatory syndrome in children (MIS-C).
Observation:
- A seven-month-old male presented with ileocecal intussusception (ICI).
- The case presented diagnostic complexities due to concurrent viral co-infections.
- Multisystem inflammatory syndrome in children (MIS-C) gradually emerged during the patient's hospitalization.
Findings:
- This case underscores the potential role of COVID-19 and MIS-C in the etiology of pediatric intussusception.
- The interplay of viral infections and MIS-C complicated the diagnosis of ICI in this infant.
- The presentation emphasizes the need to consider COVID-19-related conditions in children with intussusception.
Implications:
- Expanding the understanding of COVID-19 and MIS-C as triggers for ICI in pediatric populations.
- Highlighting the diagnostic challenges posed by co-infections and evolving MIS-C in infants with intussusception.
- Informing clinical suspicion and management strategies for intussusception in the context of the COVID-19 pandemic.
Abstract:
Ileocecal intussusception (ICI) is the most common abdominal emergency and cause of intestinal obstruction in young children, carrying a high risk of mortality and morbidity. Enteric viral infectious and inflammatory syndromes are known triggers for intussusception (ileoileal and ileocolic) by causing mesenteric lymphoid hyperplasia that may act as a leading point allowing the bowel to invaginate into itself. Gastrointestinal (GI) symptoms are common in children with coronavirus disease 2019 (COVID-19) infection, with a subset of patients solely having GI complaints at the time of presentation. COVID-19 as a trigger for intussusception in children has been hypothesized and suggested in multiple cases reported to date, both during the acute phase of illness and as a part of multisystem inflammatory syndrome in children (MIS-C). We present a seven-month-old male who developed ICI and became a diagnostic dilemma due to viral co-infections and the gradual emergence of MIS-C during the hospital stay. We are describing this presentation in an attempt to expand the understanding of the implications of COVID-19 and MIS-C in this young and unique age group.
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