Intussusception in a child with COVID-19 in the USA

Abstract

COVID-19, caused by the novel coronavirus strain SARS-CoV-2 that emerged in late 2019, has resulted in a global pandemic. COVID-19 was initially believed to occur less frequently in children with relatively mild disease. However, severe disease and varied presentations have been reported in infected children, one of such being intussusception. There have only been three reported cases of intussusception in the pediatric population infected with COVID-19. In this paper, we will discuss the management and treatment of a novel fourth case of COVID-19-associated intussusception. This case is the first reported in the USA and suggests that COVID-19 may be implicated in the development of intussusception. Pediatricians should consider the possibility of intussusception when a child with COVID-19 presents with abdominal pain.

Keywords: COVID-19; Coronavirus; Intussusception; Pediatrics; SARS-CoV-2.

Fig. 1

a Frontal view abdominal radiograph shows an elongated filling defect (arrow) within the ascending colon and hepatic flexure with an air-filled transverse colon distally, consistent with the “colon cutoff sign” of intussusception. b Transverse gray-scale abdominal sonogram shows concentric alternating echogenic and hypoechoic bands (arrow), consistent with the target sign of intussusception. No lead points including enlarged lymph nodes were identified on sonographic examination

Fig. 2

Hydrostatic reduction of intussusception using Gastrografin contrast solution. a Initial fluoroscopic image shows an ileocolic intussusception as an intracolonic filling defect at the level of the hepatic flexure (arrow). The distal colon is opacified by contrast up to the level of the intussusceptum. b, c Progressive unfolding of the telescoped bowel (arrows). d Complete reduction of the previously noted intussusception with opacification of the entire colon and retrograde filling of the ileum