Abo-Halawa Nezar, Negm Mohamed A, Arafa Mohamed, Fathy Mohamed
Pediatric Surgery, Faculty of Medicine, South Valley University, Qena, Egypt.
Faculty of Medicine, South Valley University, Qena, Egypt.
Front Pediatr. 2024 Sep 30;12:1400638. doi: 10.3389/fped.2024.1400638. eCollection 2024.
Acute abdominal pain in pediatrics is a medical emergency that requires special attention. During COVID-19 pandemic, this disease presented in pediatric age by different presentations including abdominal presentations.The affected children are presented with abdominal pain, which may be caused by surgical causes or by the virus itself that necessitate surgical consultation.
This study highlights the impact of the coronavirus pandemic on pediatric patients with acute abdominal pain regarding the presentation, clinical evaluation, and surgical management.
A retrospective cohort study was done through the collection of data from medical records and authors' data repositories of pediatric patients presented with acute abdomen from March 2020 to March 2022, in three pediatric surgery tertiary centers.
Eighty-four pediatric patients with acute abdominal pain were included in this study. The diagnosis of acute appendicitis was found in 31 patients (36.9%). Generalized abdominal pain was noted in 17 patients (20.2%) and presentation mimicked acute cholecystitis was occured in 14 patients (16.7%). ultrasonography revealed intussusception in 12 cases (14.3%). Multisystem inflammatory syndrome in children (MIS-C) was present in 9 cases (10.7%) and only one case of pancreatitis (1.2%). Conservative management was successful in 66 cases (78.6%), while operative intervention was needed in18 cases (21.4%).
During the COVID-19 pandemic, acute abdominal pain in children was frequently observed. Careful follow up is critically important as most cases do not necessitate surgical intervention. It is crucial to consider COVID-19 as a differential diagnosis in children presenting with acute abdominal pain, particularly in cases of atypical appendicitis and intussusception to prevent unnecessary surgical procedures.
小儿急性腹痛是一种需要特别关注的医疗急症。在新冠疫情期间，该疾病在儿童期有不同的表现形式，包括腹部症状。患病儿童会出现腹痛，这可能由外科病因引起，也可能由病毒本身导致，需要外科会诊。
本研究强调了新冠疫情对小儿急性腹痛患者在临床表现、临床评估和外科治疗方面的影响。
通过收集2020年3月至2022年3月期间在三个小儿外科三级中心就诊的小儿急腹症患者的病历数据和作者的数据储存库，进行了一项回顾性队列研究。
本研究纳入了84例小儿急性腹痛患者。31例（36.9%）被诊断为急性阑尾炎。17例（20.2%）出现全腹疼痛，14例（16.7%）的表现类似急性胆囊炎。超声检查发现12例（14.3%）肠套叠。9例（10.7%）出现儿童多系统炎症综合征（MIS-C），仅1例（1.2%）胰腺炎。66例（78.6%）保守治疗成功，18例（21.4%）需要手术干预。
在新冠疫情期间，小儿急性腹痛较为常见。由于大多数病例不需要手术干预，仔细随访至关重要。对于出现急性腹痛的儿童，尤其是非典型阑尾炎和肠套叠病例，将新冠考虑为鉴别诊断以防止不必要的手术操作至关重要。
