Abstract
Background.
Multisystem Inflammatory syndrome in children (MIS-C) is an uncommon condition associated with
previous COVID-19 infection or possible contact with COVID-19 positive person. Majority of MIS-C
patients present to emergency department with fever and gastrointestinal symptoms, which may
mimic acute surgical pathologies, bringing potential pitfalls in decision making.
Case presentation.
Case Nr.1. A 4-year-old female presented with 4-day fever, abdominal pain, emesis, and diarrhea. On
admission serum inflammation markers were elevated, an ultrasound showed mesadenitis with no
visible appendix, and abdominal X-ray suspected ileus. Due to suspicion of complicated appendicitis
diagnostic laparoscopy was performed and revealed no pathology except cloudy viscous
intrabdominal fluid. Later patient’s condition worsened, pneumonia developed, and she was defined
as MIS-C case, received treatment in intensive care unit and was discharged, with total 17 days of
hospital stay.
Case Nr.2. A 17-year-old male presented with 2-day fever and abdominal pain. On admission serum
inflammation markers were elevated, an ultrasound and CT-scan showed mesadenitis. Conservative
treatment was started, but condition worsened and due to suspicion of complicated intraabdominal
infection diagnostic laparoscopy was performed, and revealed hemorrhagic mesadenitis and
greenish, cloudy fluid. Later cardiac symptoms developed, and patient was defined as MIS-C case,
received treatment in intensive care unit and was discharged, with total 18 days of hospital stay.
Conclusion.
In patients presenting with acute abdominal pain, fever and high serum inflammation markers,
closer attention to the epidemiological history of COVID-19, highlighting potential MIS-C diagnosis.
This may lower the rate of negative laparoscopies.
Multisystem Inflammatory syndrome in children (MIS-C) is an uncommon condition associated with
previous COVID-19 infection or possible contact with COVID-19 positive person. Majority of MIS-C
patients present to emergency department with fever and gastrointestinal symptoms, which may
mimic acute surgical pathologies, bringing potential pitfalls in decision making.
Case presentation.
Case Nr.1. A 4-year-old female presented with 4-day fever, abdominal pain, emesis, and diarrhea. On
admission serum inflammation markers were elevated, an ultrasound showed mesadenitis with no
visible appendix, and abdominal X-ray suspected ileus. Due to suspicion of complicated appendicitis
diagnostic laparoscopy was performed and revealed no pathology except cloudy viscous
intrabdominal fluid. Later patient’s condition worsened, pneumonia developed, and she was defined
as MIS-C case, received treatment in intensive care unit and was discharged, with total 17 days of
hospital stay.
Case Nr.2. A 17-year-old male presented with 2-day fever and abdominal pain. On admission serum
inflammation markers were elevated, an ultrasound and CT-scan showed mesadenitis. Conservative
treatment was started, but condition worsened and due to suspicion of complicated intraabdominal
infection diagnostic laparoscopy was performed, and revealed hemorrhagic mesadenitis and
greenish, cloudy fluid. Later cardiac symptoms developed, and patient was defined as MIS-C case,
received treatment in intensive care unit and was discharged, with total 18 days of hospital stay.
Conclusion.
In patients presenting with acute abdominal pain, fever and high serum inflammation markers,
closer attention to the epidemiological history of COVID-19, highlighting potential MIS-C diagnosis.
This may lower the rate of negative laparoscopies.
| Original language | English |
|---|---|
| Pages | 226 |
| Number of pages | 1 |
| Publication status | Published - 2022 |
| Event | 23rd Annual Congress of the European Paediatric Surgeons’ Association (EUPSA) - Hilton Hotel Tel Aviv, Telaviv, Israel Duration: 29 Jun 2022 → 2 Jul 2022 Conference number: 23 http://www.eupsa.info/event/23rd-eupsa-annual-congress/ https://www.emedevents.com/c/medical-conferences-2022/23rd-european-paediatric-surgeons-association-eupsa-annual-congress |
Congress
| Congress | 23rd Annual Congress of the European Paediatric Surgeons’ Association (EUPSA) |
|---|---|
| Abbreviated title | EUPSA 2022 |
| Country/Territory | Israel |
| City | Telaviv |
| Period | 29/06/22 → 2/07/22 |
| Internet address |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)