Covid-19 continues to spread at an unprecedented pace, sparing no country in the world and including almost all ages. Although at the beginning of the pandemic, it was thought that the virus did not affect children, however over time, in different countries, more and more cases of children with Covid-19 begun to appear, though rarely among them were recorded any victims.
However, the clinical picture of infections with this virus in children was much more challenging than in adults.
In this article, we will present the case of three children of ages 4 to 14 years, with signs of acute abdomen, respectively with acute abdominal pain, fever, vomiting, and in whom acute appendicitis was suspected. In all three patients, anamnestic data showed positive family members infected with covid-19.
All three children were sent to the surgery ward for follow-up and further treatment.
The laboratory analyzes in all of them resulted in increased values of both erythrocyte sediment and CRP, while only in one of them the values of LDH and transaminases (AST, ALT) were also increased.
Ultrasonographic examination of the abdomen in two children showed the presence of a small amount of free fluid in the abdomen and mesentery thickening with several packets of enlarged lymph nodes. Radiography of the lungs did not show pulmonary lesions in any of the children. Body temperature ranged from 37.2 to 38.50C, while urine was within the normal range.
All children were hospitalized and kept under observation for several consecutive days. At the same time, they were treated with antibiotics of the group of cephalosporins of the third generation, as well as with antipyretics (paracetamol).
As their condition improved and the abdominal pain subsided completely, they were released from the hospital with instructions to continue the rest and taking vitamins at home in the form of ready-made preparations for children.
Conclusion: While the Covid-19 pandemic is rapidly spreading and not sparing even children, pediatricians and surgeons must be very cautious in treating children with acute abdominal pain since infections with Covid-19, and not surgical diseases, might be the real cause of these concerns.
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