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儿童 COVID-19 相关非创伤性脾破裂。

Atraumatic splenic rupture in a child with COVID 19.

机构信息

PICU, UHC "Mother Theresa", Tirane, Albania.

Department of Radiology, UHC "Mother Theresa", Tirane, Albania.

出版信息

BMC Pediatr. 2022 May 21;22(1):300. doi: 10.1186/s12887-022-03353-8.

Abstract

BACKGROUND

The majority of children with COVID-19 have only minor symptoms or none at all. COVID-19, on the other hand, can cause serious illness in some children, necessitating hospitalization, intensive care, and invasive ventilation. Many studies have revealed that SARS-CoV-2 affects not only the respiratory system, but also other vital organs in the body. We report here a child with an atraumatic splenic rupture as the initial and only manifestation of COVID-19.

CASE PRESENTATION

A 13-year-old boy with clinical signs of acute abdomen, left-sided abdominal pain, and hemodynamic instability was admitted to the PICU in critical condition. His parents denied any trauma had occurred. In addition to imaging tests, a nasopharyngeal swab was taken for COVID-19 testing, which was positive. The thoracic CT scan was normal, whereas the abdominal CT scan revealed hemoperitoneum, splenic rupture, and free fluid in the abdomen.

CONCLUSIONS

The spleen is one of the organs targeted by the SARS-CoV-2. Splenic rupture, a potentially fatal and uncommon complication of COVID-19, can be the first and only clinical manifestation of the disease in children. All pediatricians should be aware of the possibility of atraumatic splenic rupture in children with COVID-19.

摘要

背景

大多数 COVID-19 患儿仅有轻微症状或无症状。然而,COVID-19 可导致部分患儿病情严重,需要住院、重症监护和有创通气。许多研究表明,SARS-CoV-2 不仅影响呼吸系统,还影响身体其他重要器官。我们在此报告 1 例以创伤性脾破裂为 COVID-19 首发且唯一表现的患儿。

病例介绍

13 岁男孩以急性腹痛、左侧腹痛和血流动力学不稳定的临床症状为表现,收入 PICU 时情况危急。其父母否认有任何外伤史。除影像学检查外,还进行了鼻咽拭子 COVID-19 检测,结果为阳性。胸部 CT 扫描正常,而腹部 CT 扫描显示腹腔积血、脾破裂和腹腔游离液体。

结论

脾是 SARS-CoV-2 的靶器官之一。脾破裂是 COVID-19 的一种罕见但潜在致命的并发症,可作为儿童 COVID-19 的首发且唯一临床表现。所有儿科医生都应意识到 COVID-19 患儿存在创伤性脾破裂的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec92/9124409/1190aa6463cd/12887_2022_3353_Fig1_HTML.jpg

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