Acute Appendicitis in Multisystem Inflammatory Syndrome

Samprathi, Madhusudan; Sridhar, Magadi Gopalakrishna; Ramachandra, Prakash; Kulkarni, Sudhindra; Vemgal, Prakash

doi:10.1007/s12098-021-03767-9

Cited by 1 publication

(2 citation statements)

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“…Since he was diagnosed with MIS-C in time, the boy was not operated on. Normal leukocyte counts, low platelets, significantly elevated inflammatory markers, and echocardiographic changes may confirm MIS-C (59) . In a study by Al Maskari et al it is important to note that two of the six patients, suffering from MIS-C, presented to them with an acute abdomen.…”

Section: Discussionmentioning

confidence: 98%

“…appendicitis, segmental intestinal ischaemia) which need swift surgical treatment Al Lawati et al (2021) (55) Given the risk of severity and rapid deterioration of children with MIS-C, we recommend that surgeons, emergency physicians and paediatricians have a high index of MIS-C suspicion when managing children and adolescents with fever and acute abdomen during the current pandemic Borgi et al (2021) (56) A patient with MIS-C is considered to have a refractory disease when the child has persistent fever and/or significant end-organ involvement despite initial immunomodulatory treatment Lee et al (2021) (57) Early recognition by disease awareness and prompt management are key to saving the lives of children affected by MIS-C. The benefits of immunomodulatory therapy have been suggested in both MIS-C and severe paediatric COVID-19 patients, even though no guidelines support the use of one immunomodulatory therapy over another Lishman et al (2020) (58) Paediatricians that diagnose MIS-C should be vigilant and continue to carefully evaluate children for surgical complications, including appendicitis and perforation, particularly if abdominal pain is part of the presenting complaint (59) Normal leukocyte count, low platelets, significantly raised inflammatory markers, and echocardiographic changes can confirm MIS-C Al Maskari et al (2021) (60) Early diagnosis and referral to centres equipped with the required subspecialties are recommended. It should be noted that the severity of the disease is transient, usually resulting in high survival rates with proper supportive treatment.…”

Section: Discussionmentioning

confidence: 99%

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Abdominal pain and appendicitis in children during the COVID-19 pandemic – do we need to be especially careful?

Bašković¹

2022

Pediatr Med Rodz

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COVID-19 (coronavirus disease 2019) in children is relatively mild, so it is easy to make a misdiagnosis in the early stages if it presents only with respiratory symptoms. At the time of the pandemic, testing for SARS-CoV-2 is important in all paediatric patients who have fever and acute abdominal pain with diarrhoea or vomiting, to differentiate acute COVID-19 or possible multisystem inflammatory syndrome in children (MIS-C) from acute appendicitis, and thus avoiding unnecessary surgery. On the other hand, early accurate diagnosis and consequent appropriate surgical and antibiotic treatment of appendicitis are important because they can prevent complications such as abscess formation and other postoperative complications. Delayed diagnosis can lead to significant morbidity that can outweigh the damage caused by COVID-19 alone. The fact that at the time of the COVID-19 pandemic radiological examination also has its limitations and can very often show a false-positive finding in children with MIS-C must also be taken into account. It is very important that paediatric surgeons are aware of the gastrointestinal manifestations of acute COVID-19 or MIS-C, and are able to distinguish this new entity from the surgical pathologies it often mimics.

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Section: Discussionmentioning

confidence: 98%