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