Management of acute abdomen during the active disease course of COVID-19 and multisystem inflammatory syndrome in children

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Boybeyi-Turer Ö., Ozsurekci Y., Gurlevik S. L., Oygar P. D., Soyer T., Tanyel F. C.

Surgery Today, cilt.52, sa.9, ss.1313-1319, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 52 Sayı: 9
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s00595-022-02512-9
  • Dergi Adı: Surgery Today
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.1313-1319
  • Anahtar Kelimeler: Abdominal pain, Gastrointestinal symptom, MIS-C, COVID-19, Pandemics, Children
  • Hacettepe Üniversitesi Adresli: Evet

Özet

© 2022, The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.Purpose: To evaluate the management of children with severe gastrointestinal symptoms during the disease course of COVID-19 and multisystem inflammatory syndrome (MIS-C). Methods: After ethical approval, we reviewed the medical records, retrospectively, of children with COVID-19 or MIS-C requiring surgical consultation for severe gastrointestinal symptoms. Results: The subjects comprised 15 children, 13 with MIS-C and 2 with COVID-19. Twelve children (80%) had been in known close contact with a person with SARS-CoV-19 and 13 were positive for Anti-SARS-CoV-2 IgG. All the children had experienced fever for at least 1 day and had signs of involvement of two or more systems. Three patients required surgical intervention: one underwent surgical exploration with a presumptive diagnosis of acute appendicitis in the referring center and was transported to our center following clinical deterioration, where a diagnosis of MIS-C was confirmed; and the remaining two developed appendicitis during hospitalization for COVID-19. All three patients had a longer duration of abdominal pain, a higher number of lymphocytes, and a lower level of inflammatory markers than the non-surgically managed patients. None of the patients presenting with MIS-C underwent surgical exploration. Conclusion: Gastrointestinal involvement may mimic acute abdomen in children with COVID-19. Thus, children presenting with acute abdomen in the pandemic era require careful evaluation and prompt diagnosis to avoid unnecessary surgical intervention.