The major diversity in treatment regimens among published studies makes outcomes difficult to compare. However, given the results of the different cases reported in the literature and of our own experience, we suggest a possible beneficial effect of octreotide and somatostatin on closure of enterocutaneous fistula in these patients.
Introduction: Pediatric patients with coronavirus disease 2019 (COVID-19) account for less than 5% of
the total incidence. The scientific literature reports that most patients are asymptomatic or present mild
symptoms. However, they may only manifest gastrointestinal symptoms and even present an acute
abdomen; a severe form of presentation has been reported, called multisystem inflammatory syndrome in
children.
Case Presentation: We report a 10-year-old girl who presents COVID-19 in the form of an acute abdomen
because of severe sigmoiditis who developed multisystem inflammatory syndrome together with shock. The
patient fully recovered without sequelae with medical treatment. We provide computed tomography and
ultrasound images and review scientific information available on gastrointestinal COVID-19
pathophysiology from the pediatric point of view.
Conclusion: A high index of suspicion is needed for diagnosing COVID-19 in the event of any pediatric
acute abdomen during the pandemic, and screening should be undertaken even without an epidemiologic
setting and in the absence of respiratory symptoms or radiologic chest signs because acute abdomen could
be a clinical presentation of MIS-C in children.
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