Acute abdomen in COVID-19 disease: the pediatric surgeon's standpoint.

Autor:	Rico Espiñeira C; Pediatric Surgery Department. Niño Jesús Pediatric University Hospital. Madrid (Spain)., Souto Romero H; Pediatric Surgery Department. Niño Jesús Pediatric University Hospital. Madrid (Spain)., Espinosa Góngora R; Pediatric Surgery Department. Niño Jesús Pediatric University Hospital. Madrid (Spain)., Espinoza Vega ML; Pediatric Surgery Department. Niño Jesús Pediatric University Hospital. Madrid (Spain)., Alonso Calderón JL; Pediatric Surgery Department. Niño Jesús Pediatric University Hospital. Madrid (Spain).
Jazyk:	English; Spanish; Castilian
Zdroj:	Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica [Cir Pediatr] 2021 Jan 01; Vol. 34 (1), pp. 3-8. Date of Electronic Publication: 2021 Jan 01.
Abstrakt:	Objective: To describe our experience in the diagnostic and therapeutic management of patients with acute abdomen as the main manifestation of SARS-CoV-2 infection. Material and Methods: A descriptive study of patients with clinical signs of acute abdomen diagnosed with COVID-19 and admitted at out healthcare facility from April 1 to May 10, 2020 was carried out. Clinical records were reviewed for data collection purposes. Results: A series of 14 patients (9 male and 5 female) with a median age of 9.5 years was analyzed. All patients had abdominal pain. There were 11 patients with fever, 9 patients with vomit or diarrhea, and 9 patients with clinically suspected surgical pathology (acute appendicitis or peritonitis). Increased acute phase reactants and coagulation disorders were a common characteristic at blood tests. An abdominal ultrasonography was carried out in all patients, and a CT-scan was performed in 4 patients, which demonstrated inflammatory signs in the terminal ileum, the ileocecal valve and the ascending colon, as well as gallbladder edema. Conservative management was decided upon in all patients except one, and eight patients required intensive care admission for support treatment. Conclusions: Gastrointestinal symptoms can be the primary manifestation of the new coronavirus infection, which simulates an acute abdomen with a potentially unfavorable evolution. For an accurate diagnosis to be achieved, a good clinical record and a comprehensive physical exploration, as well as complementary tests in search of characteristic findings of COVID-19, should be carried out.
Databáze:	MEDLINE
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