Abdominal manifestation of multisystemic inflammatory syndrome in children

• Published in: Journal of pediatric surgery case reports Vol. 74; p. 102042
• Main Authors: Ardila Gómez, Iván José, López, Pilar Pérez, Duque, Darling Carvajal, García, Doris Martha Salgado, Romero, Andres Felipe, Vega, Martha Rocío Vega, Ramos Castañeda, Jorge Andres
• Format: Report
• Language: English
• Published: 01.11.2021
• ISSN: 2213-5766; 2213-5766
• DOI: 10.1016/j.epsc.2021.102042

SUMMARYMultisystemic inflammatory syndrome (MIS-C) can develop as a complication of SARS CoV-2 infection, involving the gastrointestinal system mainly by vasoconstriction, edema, glandular hyperplasia, and a procoagulant state leading to direct tissue injury. METHODology: a series of cases including 8 patients with MIS-C treated in two highly complex institutions is presented. These patients, had abdominal symptoms of surgical management. RESULTSThe average age was 9.5 years and the most frequent symptoms were fever, abdominal pain, diarrhea (100%); in addition, 87.5% presented shock. The diagnosis of SARS CoV-2 was confirmed by RT-PCR test in 37.5%, antigen 12.5% and the rest of the patients showed IgM and IgG antibodies. In laboratories, the increase in acute phase reactants, Erythrocyte Sedimentation Rate (ESR), C-reactive protein, procalcitonin, as well as troponin, D dimer and proBNP, is highlighted. The surgical outcome documented 2 patients with a normal appendix, 3 patients with edematous appendicitis, and 3 patients with complicated appendicitis. CONCLUSIONSpatients with MIS-C display abdominal symptoms similar to those present in surgical emergencies and a non-negligible number of cases require surgical exploration. This condition poses a new differential diagnosis to the surgical abdomen in pediatric patients.