Abstract
Coronavirus disease 2019 (COVID-19) occurs in children as well as adults and it is mainly associated with symptoms of respiratory and gastrointestinal infections. The patient was a 13-year-old child who had no symptoms of a respiratory infection and complained of abdominal pain and vomiting. A COVID-19 polymerase chain reaction (PCR) test was requested, which was positive. Based on laboratory test results indicating high serum amylase and lipase levels and imaging findings, acute pancreatitis was diagnosed, and after supportive treatment, the patient was discharged in good general condition. During the SARS-CoV-2 pandemic, children who refer to medical centers with gastrointestinal symptoms and pancreatitis should be checked for COVID-19.
Highlights
Coronavirus disease 2019 (COVID-19) is usually mild in children and adolescents up to 18 years of age and it is asymptomatic in 16% of cases
We report a rare case of a 13-year-old child with COVID-19 who referred with symptoms of acute pancreatitis
Acute pancreatitis should be diagnosed if the patient presents with at least two of the following three criteria: abdominal pain, serum amylase and lipase levels higher than three times the normal range, and imaging findings indicating inflammation and involvement of the pancreas.[5]
Summary
Coronavirus disease 2019 (COVID-19) is usually mild in children and adolescents up to 18 years of age and it is asymptomatic in 16% of cases. The pain started suddenly and intermittently from the day before the visit and was accompanied by non-bilious and non-bloody vomiting It was more severe in the epigastric region and radiated to the patient’s back, which was exacerbated by lying down and the patient tended to lean forward. Surgical consultation was requested to evaluate causes of the acute abdomen. According to the results of Gholami and Arjmand history of trauma, no history of underlying diseases, no bacterial and viral causes of pancreatitis considering negative blood culture, significantly high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels at admission, no fever, and normal ultrasound of abdomen and pancreas), SARS-COV-2-associated pancreatitis was diagnosed. According to blood cell count, PCR test result, blood culture result, and rejection of bacterial causes of pancreatitis, an antibiotic therapy (meropenem) was started. In addition to a significant increase in serum amylase and lipase, a high level of serum D-dimer was observed in results, and subcutaneous enoxaparin was started to prevent the risk of thrombosis
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