Sars-Cov-19 Enfeksiyonu Sonrası Adeziv Bağırsak Tıkanıklığına Neden Olan Cerrahi Sonrası Yaygın Peritonit: Olgu Sunumu

Öz

Amacımız cerrahi sonrası sonuçlarda COVİD-19 ilişkili tanı ve tedavi güçlüklerini tartışmaktır. Yenidoğan döneminde jejunal atrezi nedeniyle ameliyat olan 5 yaşında erkek hasta tekrarlayan safralı kusma nedeniyle başvurdu. Üst GİS tetkikinde mekanik tıkanıklık olmadan jejunal segment dilatasyonu izlendi. Dilate jejunuma rezeksiyon ve anastomoz yapıldı. Sonrasında, anastamoz kaçağı olmayan hastada peritonit bulguları gelişti. İkinci cerrahi eksplorasyonda zor ayrılabilen adeziv bantlara neden olan kalınlaşmış fibröz bantlar ve yaygın peritonit izlendi. Hastanın tekrarlanan öyküsünden büyükannesinde cerrahi öncesinde COVİD-PCR pozitifliği olduğu öğrenildi. Dolayısıyla, pandemi süreci boyunca atipik post-operatif seyir yaşayan hastalarda COVİD-19 araştırması yapılmalıdır.

Anahtar Kelimeler

• SARS-CoV-2
• peritonit
• adeziv tıkanıklık
• postoperatif
• çocuk

Postoperative Diffuse Peritonitis Causing Adhesive Bowel Obstruction Possibly Due to Sars-Cov-19 Infection: Report of a Case

Öz

Aim is to discuss diagnostic and therapeutic difficulties in COVID-19 related postoperative outcomes. A 5-year-old boy operated for jejunal atresia in neonatal period admitted with recurrent bilious vomiting. The upper GI series revealed dilated jejunum and absence of mechanical obstruction. The dilated jejunal segment was excised and anastomosis was performed. Later, he developed peritonitis without signs of anastomotic leaks. The second surgical exploration revealed diffuse peritonitis causing thickened and fibrous bowel loops causing hardly lysable adhesions. Then, his grandmother was learned to be COVID-PCR positive. Therefore, patients with atypical postoperative course should be investigated for possible COVID-19 during pandemics.

Anahtar Kelimeler

• SARS-CoV-2
• peritonitis
• adhesive obstruction
• postoperative
• children

Kaynakça

1. Chiappini E, Licari A, Motisi MA, Manti S, Marseglia GL, Galli L, et al. Gastrointestinal involvement in children with SARS-COV-2 infection: An overview for the pediatrician. Pediatr Allergy Immunol 2020; 31: 92-5.
2. Matthai J, Shanmugam N, Sobhan P. Coronavirus disease (COVID-19) and the gastrointestinal system in children. Indian Pediatr 2020; 57: 533-5.
3. Malhotra A, Sturgill M, Whitley-Williams P, Li YH, Esochaghi C, Rajasekhar H, et al. Pediatric COVID-19 and Appendicitis: A Gut Reaction to SARS-CoV-2? Pediatr Infect Dis J 2020; 40: 49-55.
4. Makrinioti H, MacDonald A, Lu X, Wallace S, Jobson M, Zhang F, et al. Intussusception in Children with Severe Acute Respiratory Syndrome Coronavirus Infection. J Pediatric Infect Dis Soc 2020; 17: 504-6.
5. Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. E-Clinical Medicine 2020; 5: 100331.
6. Zou H, Lu J, Liu J, Wong JH, Cheng S, Li Q, et al. Characteristics of pediatric multi-system inflammatory syndrome (PMIS) associated with COVID-19: a meta-analysis and insights into pathogenesis. Int J Infect Dis 2020; 14: 319-26.
7. Foster CE, Marquez L, Davis AL, Tocco E, Koy TH, Dunn J, et al. A Surge in Pediatric Coronavirus Disease 2019 Cases: The Experience of Texas Children’s Hospital from March to June 2020. J Pediatric Infect Dis Soc 2021; 10: 593-8.
8. Wang JG, Cui HR, Tang HB, Deng XL. Gastrointestinal symptoms and fecal nucleic acid testing of children with 2019 coronavirus disease: a systematic review and meta-analysis. Sci Rep 2020; 20:17846.