S3545 Pneumomediastinum and Pneumopericardium in a Teenager With Coronavirus Disease 2019 (COVID-19)

Abstract

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has been declared pandemic by the World Health Organization (WHO) with the rapidly increasing number of infectious cases. The current literature is deficient regarding pediatric population data. We report a case of a seventeen-year-old female, known history of marijuana use, presented to the emergency department with complaints of abdominal pain, nausea, and vomiting and was found to have pneumopericardium and pneumomediastinum. CASE DESCRIPTION/METHODS: The patient presented to the emergency room with a three days history of abdominal pain, nausea, and vomiting and one day history of diarrhea. She lived with her grandmother who was presumed to be COVID-19 positive based on symptoms. Her admission labs revealed pyuria suspicious for urinary tract infection. The remainder of her serology was unremarkable. Patient’s nasal swab was PCR positive for SARS-CoV-2. Due to abdominal pain, a CT-Scan of the abdomen and pelvis was obtained which was concerning for pneumomediastinum and pneumopericardium. CT-scan thorax confirmed the findings and revealed extensive subcutaneous emphysema in the neck soft tissue. Contrast Barium Esophagogram was done which was unremarkable, without any extraluminal contrast leakage. The patient was admitted to the pediatric intensive care unit for observation and supportive care. DISCUSSION: The patient recovered to her baseline with the supportive treatment and did not require any respiratory support during the hospital stay.