Phlegmonous appendicitis in children with coronavirus infection COVID-19

Abstract

The increase in cases of appendicitis observed during the COVID-19 pandemic requires an analysis of the causes of this situation and the determination of tactics for the diagnostic and surgical treatment of these patients. In 2020–2022 at the St. Vladimir Children’s Clinical Hospital, among hospitalized and operated patients for appendicitis, 16 patients were identified who simultaneously had a positive result of testing a swab from the nasopharynx for the presence of SARS-CoV-2 RNA. All patients are schoolchildren with a predominance of high school students. The disease began acutely with the appearance of abdominal pain, accompanied by repeated vomiting. There was no high fever, in half of the cases the temperature was subfebrile (37.2–37.8 °C), in other cases it remained normal. The respiratory syndrome preceded the abdominal one in three patients, and six more patients had hyperemia of the palatine arches and posterior pharyngeal wall. Respiratory failure, hypoxia were absent. Chest CT showed no changes. In all cases, abdominal ultrasound revealed ECHO signs of inflammatory transformation of appendix fragments. Operations were performed laparoscopically. The results of the morphological study of the removed appendix corresponded to the diagnosis of phlegmonous appendicitis, periappendicitis, mesenteriolitis. The postoperative course was uncomplicated, the pain syndrome was stopped, there was an improvement in clinical and laboratory parameters. Conclusion: phlegmonous appendicitis was observed in patients with coronavirus infection; surgical treatment led to the recovery of patients.