Pediatric Surgery Department. Niño Jesús Pediatric University Hospital. Madrid (Spain).
Cir Pediatr. 2021 Jan 1;34(1):3-8.
To describe our experience in the diagnostic and therapeutic management of patients with acute abdomen as the main manifestation of SARS-CoV-2 infection.
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.
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.
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.
描述我们在以 SARS-CoV-2 感染为主要表现的急性腹痛患者的诊断和治疗管理方面的经验。
对 2020 年 4 月 1 日至 5 月 10 日在我们医疗机构就诊的以 COVID-19 诊断并伴有临床急性腹痛表现的患者进行了描述性研究。回顾了临床记录以进行数据收集。
分析了一系列 14 例患者（9 名男性和 5 名女性），中位数年龄为 9.5 岁。所有患者均有腹痛。11 例患者有发热，9 例患者有呕吐或腹泻，9 例患者有临床疑似外科病理学（急性阑尾炎或腹膜炎）。血液检查中常见的特征是急性期反应物增加和凝血功能障碍。所有患者均进行了腹部超声检查，4 例患者进行了 CT 扫描，显示末端回肠、回盲瓣和升结肠有炎症征象，以及胆囊水肿。除 1 例患者外，所有患者均决定进行保守治疗，8 例患者需要入住重症监护病房进行支持治疗。
胃肠道症状可能是新型冠状病毒感染的主要表现，其模拟具有潜在不利演变的急性腹痛。为了做出准确的诊断，应进行详细的临床记录和全面的体格检查，并进行补充检查以寻找 COVID-19 的特征性发现。
