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COVID-19 相关肠套叠:病例系列及文献复习。

COVID-19-Related Intussusception: A Case Series and Review of the Literature.

机构信息

Division of Pediatric Surgery, Oklahoma Children's Hospital, Oklahoma City, Oklahoma, USA.

School of Medicine, The University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA.

出版信息

Surg Infect (Larchmt). 2022 Oct;23(8):712-716. doi: 10.1089/sur.2022.139. Epub 2022 Aug 18.

Abstract

Ileocolic intussusception is a common gastrointestinal emergency that occurs in infancy. Many cases are caused by anatomic lead points, such as hypertrophied Peyer's patches. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), commonly presents with respiratory symptoms, however, its relation to intussusception remains unknown. Two cases are reported as well as a review of pertinent English-language literature on the topic. We present two cases of intussusception in COVID-19-positive patients, including the first known case of a lead point with tissue polymerase chain reaction (PCR) confirming COVID-19 positivity, and compare these findings to a review of the recent literature. Intussusception in COVID-19-positive patients is becoming more prevalent and more often requires operative treatment. We offer evidence that intussusception can be the presenting symptom in the absence of COVID-19-related respiratory symptoms. There also seems to be a trend toward the need for operative intervention compared with COVID-19-negative intussusception. The presence of SARS-CoV-2 can be confirmed via PCR in specific lead points (lymph nodes), directly causing the intussusception. Providers should have a low threshold to suspect and diagnose intussusception as operative treatment is more readily used in COVID-19-positive pediatric patients with gastrointestinal symptoms.

摘要

回肠-结肠肠套叠是婴儿期常见的胃肠道急症。许多病例是由解剖学上的铅点引起的,如肥大的派尔斑。引起 2019 年冠状病毒病(COVID-19)的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染通常表现为呼吸道症状,但与肠套叠的关系尚不清楚。本文报告了两例 COVID-19 阳性患者的肠套叠病例,并对该主题的相关英文文献进行了回顾。我们报告了两例 COVID-19 阳性患者的肠套叠病例,包括首例组织聚合酶链反应(PCR)证实 COVID-19 阳性的铅点病例,并将这些发现与最近文献的回顾进行了比较。COVID-19 阳性患者的肠套叠越来越常见,且更常需要手术治疗。我们提供的证据表明,肠套叠可以作为无 COVID-19 相关呼吸道症状的首发症状。与 COVID-19 阴性肠套叠相比,似乎也有需要手术干预的趋势。SARS-CoV-2 可通过特定铅点(淋巴结)的 PCR 得到证实,直接导致肠套叠。提供者应该有一个较低的门槛来怀疑和诊断肠套叠,因为在有胃肠道症状的 COVID-19 阳性儿科患者中,手术治疗更容易被采用。

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