一名6个月大婴儿的新型冠状病毒肺炎相关多处结肠穿孔：一例罕见病例报告
COVID-19-associated multiple colonic perforations in a 6-month-old infant: a rare case report.
作者信息
Anari Ali Manafi, Teymoorzadeh Ladan, Nasiri Ramez, Narimani Sajjad
机构信息
Department of Pediatrics, School of Medicine, Hazrat-e Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
Genetic Consultant, Academic Center for Education, General Practitioner, Culture, Research, Ardabil, Iran.
出版信息
BMC Pediatr. 2025 Jul 10;25(1):545. doi: 10.1186/s12887-025-05908-x.
BACKGROUND
While COVID-19 primarily manifests as a respiratory illness, gastrointestinal complications-including severe colitis and perforation-have been reported, particularly in adults. However, such presentations in infants remain exceedingly rare.
CASE PRESENTATION
A 6-month-old infant presented with lethargy and poor feeding, initially diagnosed with sepsis. Subsequent testing confirmed COVID-19 positivity. During hospitalization, the patient developed feeding intolerance, vomiting, and abdominal distension. Imaging revealed free intraperitoneal fluid with suspected perforation. Emergency laparotomy revealed perforations in the transverse and descending colon, necessitating total colectomy.
CONCLUSION
This case provides laboratory and histopathological evidence linking SARS-CoV-2 to intestinal perforation in infants, suggesting that SARS-CoV-2 may contribute to ischemic or inflammatory bowel injury leading to perforation. Early surgical intervention is critical in such scenarios. Further research is needed to establish causality and pathophysiology.
背景
虽然新冠病毒病主要表现为呼吸道疾病，但已有胃肠道并发症的报道，包括严重结肠炎和穿孔，尤其是在成人中。然而，婴儿出现此类症状的情况极为罕见。
病例报告
一名6个月大的婴儿出现嗜睡和喂养困难，最初被诊断为败血症。随后的检测证实新冠病毒呈阳性。住院期间，该患者出现喂养不耐受、呕吐和腹胀。影像学检查显示腹腔内有游离液体，怀疑有穿孔。急诊剖腹探查发现横结肠和降结肠穿孔，需要进行全结肠切除术。
结论
本病例提供了实验室和组织病理学证据，将严重急性呼吸综合征冠状病毒2与婴儿肠道穿孔联系起来，表明严重急性呼吸综合征冠状病毒2可能导致缺血性或炎症性肠损伤，进而导致穿孔。在这种情况下，早期手术干预至关重要。需要进一步研究以确定因果关系和病理生理学。
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