Diagnostics and treatment of complications of SARS-CoV-2 infection in the pediatric surgery department. An analysis based on seven clinical cases and literature review.

Introduction: Pediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2 (PIMS-TS) is a new disease, the first cases of which were observed in the spring of 2020. It affects children who have been infected with SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) and children who have been in direct contact with patients suffering from COVID-19 (coronavirus disease 2019). The disease is characterized by a wide spectrum of symptoms and the development of generalized inflammation of different organs and systems. One of the numerous symptoms may be severe abdominal pain. Aim: The aim of this study was to review the available literature and analyze the results of patients treated at the Department of Pediatric Surgery, Traumatology and Urology in Poznań in whom PIMS-TS imitated acute surgical abdominal disease. Materials and methods: material for the study was collected on the basis of medical records of patients treated at the Department of Pediatric Surgery, Traumatology and Urology of the Poznań University of Medical Sciences in the period between March 2020 and February 2021. Results: TDuring this period, seven patients met the PIMS-TS criteria and three children were qualified for surgical treatment. Only one patient had an acute surgical cause of abdominal pain. Discussions: The guidelines of the expert group at the Polish Pediatric Society and the National Consultant in the field of Pediatrics indicate the need to exclude acute surgical abdominal disease as a criterion for the diagnosis of PIMS-TS syndrome. In patients with acute abdominal pain, imaging and laboratory tests are sometimes diagnostically inconclusive, therefore exploratory laparoscopy is worth considering in order to differentiate PIMS-TS from acute surgical abdominal disease.