MIS-C-Implications for the Pediatric Surgeon: An Algorithm for Differential Diagnostic Considerations

Bibliographic Details
Title: MIS-C-Implications for the Pediatric Surgeon: An Algorithm for Differential Diagnostic Considerations
Authors: Nora Manz, Claudia Höfele-Behrendt, Julia Bielicki, Hanna Schmid, Matthias S. Matter, Isabella Bielicki, Stefan Holland-Cunz, Stephanie J. Gros
Source: Children, Vol 8, Iss 8, p 712 (2021)
Publisher Information: MDPI AG, 2021.
Publication Year: 2021
Collection: LCC:Pediatrics
Subject Terms: multisystem inflammatory syndrome in children, pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2, PIMS-TS, pediatric surgery, acute abdomen, differential diagnosis of appendicitis, Pediatrics, RJ1-570
More Details: Background: multisystem inflammatory syndrome in children (MIS-C) is a new disease associated with a recent infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Affected children can present predominantly with abdominal symptoms, fever and high inflammatory parameters that might lead to a consult by the pediatric surgeon and an indication for surgery. Methods: clinical data of three patients with MIS-C that underwent surgery were collected. Histopathological analysis of the appendix was performed. Results: we present the clinical course of three children with fever, abdominal pain and vomiting for several days. Clinical examination and highly elevated inflammation markers led to indication for laparoscopy; appendectomy was performed in two patients. Because of intraoperative findings or due to lack of postoperative improvement, all patients were reevaluated and tested positive for MIS-C associated laboratory parameters and were subsequently treated with corticosteroids, intravenous immunoglobulins, acetyl salicylic acid and/or light molecular weight heparin. Conclusions: we discuss the implications of MIS-C as a new differential diagnosis and stress the importance of assessing the previous medical history, identifying patterns of symptoms and critically surveilling the clinical course. We implemented an algorithm for pediatric surgeons to consider MIS-C as a differential diagnosis for acute abdomen that can be integrated into the surgical workflow.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2227-9067
Relation: https://www.mdpi.com/2227-9067/8/8/712; https://doaj.org/toc/2227-9067
DOI: 10.3390/children8080712
Access URL: https://doaj.org/article/16f7063ca864423c98f014cec00ba9f0
Accession Number: edsdoj.16f7063ca864423c98f014cec00ba9f0
Database: Directory of Open Access Journals
More Details
ISSN:22279067
DOI:10.3390/children8080712
Published in:Children
Language:English