Abdominal Emergency Research Articles

The Effect of Regional Anesthesia in the Management of High-risk Abdominal Emergencies During Pandemics

The Effect of Regional Anesthesia in the Management of High-risk Abdominal Emergencies During Pandemics

Management of Abdominal Surgical Emergencies at the General Reference Hospital, What Place for Laparoscopic Surgery?

Aim of the study: The purpose of this article is to report the experience of the General Reference Hospital in the surgical management of abdominal emergencies. Patients and Methods: This was a prospective study over 3 years 5 months (08/12/2017 to 31/05/2021) which concerned patients operated for an abdominal emergency at the General Reference Hospital of Niamey. Results: We had 170 patients operated for an abdominal emergency (8.37%), with a male predominance (61.50%) and a sex ratio of 1.59. The average age was 36.08 years with a standard deviation of 17.46 and extremes of 2 to 79 years. Non-traumatic abdominal emergencies dominated with 96.47%. Abdominal ultrasound was performed in 92.35% (n=157) of patients and abdominal CT scan in 35.88% (n=61). General anesthesia was performed in 97.06% of cases (n=165). The approaches were laparotomy in 72.35% (n=123) and laparoscopy in 27.65% (n=47). The most reported intraoperative diagnoses were acute appendicitis 40.59% (n=69) followed by acute peritonitis 18.82% (n= 32) and acute cholecystitis 13,53% (n= 23). The main procedures performed by laparoscopy were appendectomies, cholecystectomies and acute peritonitis in respectively 15.29%, 10.59% and 1.76% of cases. Postoperative complications represented 2.35% (n=4) in laparoscopy and 9.41% (n=16) in laparotomy. Conclusion: Abdominal emergencies at the Reference General Hospital are frequent and postoperative complications are few especially at laparoscopy, which is a first way to encourage in our context; It gives better surgical outcomes than conventional surgery.

Variation in the management of adhesive small bowel obstruction in the Netherlands: a prospective cross-sectional study.

ASBO is a frequent abdominal surgical emergency and a leading cause of morbidity and mortality in emergency surgery. The aim of this study is to provide insight into the current management of adhesive small bowel obstruction (ASBO) and associated outcomes. A nationwide prospective cross-sectional cohort study was conducted. All patients with clinical signs of ASBO admitted to participating Dutch hospitals were included during a 6 months inclusion period between April 2019 and December 2020. Ninety-day clinical outcomes were described and compared for nonoperative management (NOM) and laparoscopic and open surgery. In 34 participating hospitals, 510 patients were included, of whom 382 (74.9%) had a definitive diagnosis of ASBO. Initial management consisted of emergency surgery in 71 (18.6%) patients and NOM in 311 (81.4%) patients, 119 (31.1%) of whom required delayed surgery after failure of NOM. Surgical interventions started laparoscopically in 51.1%, of which 36.1% were converted to laparotomy. Intentional laparoscopy resulted in shorter hospital stays compared with open surgery (median 8.0 vs. 11.0 days; P <0.001) and comparable hospital mortality (5.2 vs. 4.3%; P =1.000). Oral water-soluble contrast use was associated with a decreased length of stay ( P =0.0001). Hospital stay for surgical patients was shorter in patients who were operated on within 72h of admission ( P <0.001). This nationwide cross-sectional study demonstrates shorter hospital stay in ASBO patients who received water-soluble contrast, were operated within 72h of admission or were operated with minimally invasive techniques. Results may support the standardization of ASBO treatment.

Appendicitis: Epidemioclinical and Histological Aspects at the Nianankoro Fomba Hospital in Segou

Summary: This was a single-centre prospective descriptive study carried out in the general surgery department of the Nianankoro Fomba Hospital in Segou over a period of one year. We collected a total of 53 cases of acute appendicitis which represented 14.52% of our surgical activity, 22.36% of the surgical abdominal emergencies. The sex ratio was 2.1 in favour of the male. The clinical signs were polymorphous. Patients consulted for a painful abdominal syndrome most often located in the IDF, 81.1% of cases. Palpation revealed pain in the IDF in 52 (98%) patients, tenderness in the IDF in 21 (40%) patients. Abdominal contracture and a mass in 1(2%). The signs of BLUMBERG, ROVSING and PSOÏTIS were respectively: 58.4%; 0%; 0% of cases. The rectal examination was painful in 49.0% of cases. The postoperative course was simple in 38 patients (71.1%). Complications were observed in 28.3% of our patients, including 14 parietal suppurations, and we recorded 1 case of death. The average hospital stay was 6.4 days.

Trends in the mortality, incidence and disability-adjusted life-years of appendicitis in EU15+ countries: an observational study of the global burden of disease database, 1990-2019.

Appendicitis places a substantial burden on healthcare systems, with acute appendicitis alone being the most common abdominal surgical emergency worldwide. Further characterisation of the disease burden in EU15+ countries may help optimise the distribution of healthcare resources. The aim of this observational study was to assess the trends in mortality, incidence and DALYs of appendicitis across European Union (EU) 15+ countries between the years 1990 and 2019, Supplemental Digital Content 3, http://links.lww.com/JS9/A589. Age standardised mortality rates (ASMRs), age standardised incidence rates (ASIRs) and disability adjusted life years (DALYs) data for appendicitis in males and females were extracted from the 2019 Global Burden of Disease (GBD) study. Temporal trends within the study period were analysed using Joinpoint regression analysis. The median ASMRs across EU15+ countries in 2019 were 0.08/100,000 and 0.13/100,000 for females and males, respectively. Between 1990 and 2019 the median percentage change in ASMR was -52.12% for females and -53.18% in males. The median ASIRs in 2019 for females and males were 251/100,000 and 278/100,000, respectively, with a median percentage change of +7.22% for females and +3.78% for males during the observation period. Decreasing trends in DALYs were observed over the 30-year study period, with median percentage changes of -23.57% and -33.81% for females and males, respectively, Supplemental Digital Content 3, http://links.lww.com/JS9/A589. Overall, a general trend of decreasing appendicitis ASMRs and DALYs was observed across EU15+ countries, despite small overall increases in appendicitis ASIRs, Supplemental Digital Content 3, http://links.lww.com/JS9/A589. Variations in both diagnostic and management strategies over the study period are likely contributory to the changing trends.

Epidemiological and Therapeutic Aspects of Appendicitis at the Fana Reference Health Center

Summary: Acute appendicitis is an acute inflammation of the vermiform appendix. The objective is to study acute appendicitis in the Fana reference health center. Patients and methods: prospective study which extended over a period of twelve months from January 1, 2020 to December 31, 2020. Results: 72 cases of appendicitis identified which represented 11.52% of surgical interventions, 48.98% of digestive surgical emergencies and 90.3% of our patients were received in emergency. We observed a male predominance with 55.6%, a ratio of 1.25. The most represented age group was that of 5 to 20 years, i.e. a rate of 38.9% and the average age was 27.31 ± 13.76 years with extremes ranging from 7 to 65 years. The housekeeping profession was the most dominant with a workforce of 24 or a rate of 33.3%. The majority of our patients were operated under general anesthesia with a rate of 66.7%. The Mac Burney point was the site of the incision of the majority of our patients, a rate of 87.5%. The duration of hospitalization of our patients was 5 days in 68 of our patients, a rate of 94.4%. Conclusion: Acute appendicitis is the most frequent abdominal emergency at CS Ref Fana but similar to that observed in other tropical African countries. It is a condition with low morbidity and mortality when diagnosed and treated early.

Neonatal Abdominal Surgical Emergencies: Therapeutic and Evolutionary Aspects in the Pediatric Surgery Department of the Hospital in Mali

Neonatal abdominal surgical emergencies include acquired or congenital conditions of the digestive tract of the newborn, which manifest themselves from birth to the end of the first month of life (0 to 28 days). We carried out a retro-prospective and descriptive study over three (3) years, from June 1, 2018 to May 31, 2021, the main purpose of which is to study the therapeutic and evolutionary aspects of neonatal abdominal surgical emergencies in the pediatric surgery department of the Mali Hospital.

Abdominal Emergencies in Cancer Patients.

Abdominal emergencies in cancer patients encompass a wide spectrum of oncologic conditions caused directly by malignancies, paraneoplastic syndromes, reactions to the chemotherapy or often represent the first clinical manifestation of an unknown malignancy. Not rarely, clinical symptoms are the tip of an iceberg. In this scenario, the radiologist is asked to exclude the cause responsible for the patient's symptoms, to suggest the best way to manage and to rule out the underlying malignancy. In this article, we discuss some of the most common abdominal oncological emergencies that may be encountered in an emergency department.

Abdominal Surgical Emergencies at the Fana Reference Health Centre

Introduction: Surgical abdominal emergencies are abdominal pain evolving for a few hours or a few days (less than 3 days) which can be traumatic or non-traumatic which are related to a surgical pathology. Purpose: Studying surgical abdominal emergencies at the Fana reference health center (Csref). Methodology: This was a prospective study carried out at the csref of Fana from January 1, 2022 to December 31, 2022. Results: During the study we identified 121 cases of surgical abdominal emergencies including 76 men and 45 women with a sex ratio of 1.68, the average age was 29.95 years ± 18.71. These were 6 surgical emergencies which are: Acute appendicitis (45 cases), Intestinal obstruction (32 cases), Acute peritonitis (30 cases), Traumatic hemoperitoneum (06 cases), GEU (05), Evisceration (3). Abdominal pain was the main reason for consultation. The physical examination made it possible in the majority of cases to make the diagnosis. Faced with certain doubtful cases, we requested paraclinical examinations (ultrasound in 26 cases, ASP in 56 cases and grouping/rhesus in all cases). The morbidity rate was 12.4% and mortality 6.66%. Conclusion: The frequency of surgical abdominal emergencies is high at the Csref of Fana with 20.20%. The clinical picture is polymorphous. The causes are many and varied; dominated by acute appendicitis, intestinal obstruction and peritonitis.

Operative and Non-Operative Hemoperitoneum in Blunt Abdominal Trauma, General Surgery Department, Sikasso Hospital

Blunt abdominal trauma being one of the most common abdominal emergencies; they explain the patient's indication of armed expectation in the absence of any notion of hemodynamic instability. The objectives were to determine the hospital frequency, to identify the etiologies and to analyze the therapeutic modalities. The study was retrospective and prospective from January 1, 2010 to December 31, 2018 involving 45 patients treated for hemoperitoneum in the general surgery department of Sikasso hospital. All patients admitted to the department for blunt abdominal trauma with hemoperitoneum were included. We collected 45 patients whose mean age was 18.7 years (extreme 3 - 55 years). The sex ratio was 4.6 in favor of men (37 M, 8 F). We found 23 (51.12%) cases of AVP, 13 (28.89%) cases of falls from a height, 11 (7.7%) cases of aggression, hoof kick 1 (2.22%). 19 (42.22%) patients had low haemoperitoneum, 16 (35.56%) medium abundance, 10 (22.22%) high abundance. 32 (71.11%) provided non-operative treatment with a mean hospital stay of 13.7 days (range 5 to 20). 1 patient was unstable, it was activated 24 hours later. We immediately had 12 patients (26.67%) with an average hospital stay of 16.5 days (extreme 10 -24) and the postoperative course was simple in 66.67% (8 cases). We recorded 1 death (2.22%).

O055 Robotic appendicectomy: a systematic review of feasibility

Abstract Introduction Acute appendicitis is known to be one of the most common abdominal surgical emergencies. Laparoscopic appendicectomy is considered the gold-standard management. There has been an increasing trend in the routine use of robotic surgery in abdominal surgery. However, it remains underutilised in emergency surgeries. We aimed to systematically review robotic appendicectomy (RA) procedures in elective and emergency settings and study its indications and feasibility. Methods A 20-year systematic review was performed in compliance with the PRISMA guidelines. The search was performed on PubMed, ScienceDirect and the Cochrane-Library databases. For quality assessment, Amstar 2 and MERSQI score were applied. The research protocol was registered with PROSPERO register for systematic reviews (CRD42022324582). Results A total of 1346 resulted from the systematic search, of which a final 9 articles were included in this study. A total of 174 procedures were included, 161 elective, 12 emergency and one interval RA. MERSQI mean score was 10.72 (SD= 2.56), with 4 high quality, 2 moderate and 3 low quality studies. The endpoints across the studies were: rate of conversion to open surgery, length of hospital stay, intra-operative blood loss and operative time. Conclusions Robotic appendicectomy is considered a safe and feasible technique with minimal blood loss and without conversion. The operating time and the hospital stay were within acceptable limits. Future studies are recommended to further evaluate RA with a focus on its application during emergency settings and on its cost-effectiveness.

Sarcopenia provides extra value outside the PULP score for predicting mortality in older patients with perforated peptic ulcers

BackgroundPerforated peptic ulcer (PPU) remains challenging surgically due to its high mortality, especially in older individuals. Computed tomography (CT)-measured skeletal muscle mass is a effective predictor of the surgical outcomes in older patients with abdominal emergencies. The purpose of this study is to assess whether a low CT-measured skeletal muscle mass can provide extra value in predicting PPU mortality.MethodsThis retrospective study enrolled older (aged ≥ 65 years) patients who underwent PPU surgery. Cross-sectional skeletal muscle areas and densities were measured by CT at L3 and patient-height adjusted to obtain the L3 skeletal muscle gauge (SMG). Thirty-day mortality was determined with univariate, multivariate and Kaplan–Meier analysis.ResultsFrom 2011 to 2016, 141 older patients were included; 54.8% had sarcopenia. They were further categorized into the PULP score ≤ 7 (n=64) or PULP score > 7 group (n=82). In the former, there was no significant difference in 30-day mortality between sarcopenic (2.9%) and nonsarcopenic patients (0%; p=1.000). However, in the PULP score > 7 group, sarcopenic patients had a significantly higher 30-day mortality (25.5% vs. 3.2%, p=0.009) and serious complication rate (37.3% vs. 12.9%, p=0.017) than nonsarcopenic patients. Multivariate analysis showed that sarcopenia was an independent risk factor for 30-day mortality in patients in the PULP score > 7 group (OR: 11.05, CI: 1.03-118.7).ConclusionCT scans can diagnose PPU and provide physiological measurements. Sarcopenia, defined as a low CT-measured SMG, provides extra value in predicting mortality in older PPU patients.

Analysis of Appendicitis Cases in the Japanese Adverse Drug Event Report (JADER) Database.

Appendicitis is one of the most common abdominal surgical emergencies worldwide; however, its causes remain poorly understood. The Japanese Adverse Drug Event Report (JADER) database is a spontaneous reporting system (SRS) that can be utilized to analyze the safety signals of adverse events. In this study, we investigated the association between drug use and the onset of appendicitis using the JADER database. We first used the reporting odds ratio (ROR) as the signal and found signals for appendicitis, perforated appendicitis, and complicated appendicitis for 23, 9, and 1 drug, respectively. To investigate the level of hazard over time in drug-associated appendicitis, the Weibull shape parameter β was calculated using a Weibull plot, which revealed drug-dependent patterns for changes in the risk of appendicitis over time for the eight drugs. Furthermore, logistic regression analysis was performed to account for the influence of age, sex, and primary disease, and a significant association was detected between two drugs and appendicitis. Several types of drugs, such as antitumor, antirheumatic, and anti-inflammatory drugs, were included in our analyses; however, only clozapine, which is used for patients with schizophrenia, was commonly identified in these analyses. The resulting data suggest that certain drugs may be associated with appendicitis and may require adequate attention.

Role of artificial intelligence in oncologic emergencies: a narrative review.

Oncologic emergencies are a wide spectrum of oncologic conditions caused directly by malignancies or their treatment. Oncologic emergencies may be classified according to the underlying physiopathology in metabolic, hematologic, and structural conditions. In the latter, radiologists have a pivotal role, through an accurate diagnosis useful to provide optimal patient care. Structural conditions may involve the central nervous system, thorax, or abdomen, and emergency radiologists have to know the characteristics imaging findings of each one of them. The number of oncologic emergencies is growing due to the increased incidence of malignancies in the general population and also to the improved survival of these patients thanks to the advances in cancer treatment. Artificial intelligence (AI) could be a solution to assist emergency radiologists with this rapidly increasing workload. To our knowledge, AI applications in the setting of the oncologic emergency are mostly underexplored, probably due to the relatively low number of oncologic emergencies and the difficulty in training algorithms. However, cancer emergencies are defined by the cause and not by a specific pattern of radiological symptoms and signs. Therefore, it can be expected that AI algorithms developed for the detection of these emergencies in the non-oncological field can be transferred to the clinical setting of oncologic emergency. In this review, a craniocaudal approach was followed and central nervous system, thoracic, and abdominal oncologic emergencies have been addressed regarding the AI applications reported in literature. Among the central nervous system emergencies, AI applications have been reported for brain herniation and spinal cord compression. In the thoracic district the addressed emergencies were pulmonary embolism, cardiac tamponade and pneumothorax. Pneumothorax was the most frequently described application for AI, to improve sensibility and to reduce the time-to-diagnosis. Finally, regarding abdominal emergencies, AI applications for abdominal hemorrhage, intestinal obstruction, intestinal perforation, and intestinal intussusception have been described.

Efficacy in Predicting Negative Appendectomy Rates in Operated Acute Appendicitis Patients Using the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) Score Versus Modified Alvarado Score.

Introduction Acute appendicitis is the commonest abdominal surgical emergency globally. The most accepted management of acute appendicitis is surgical, either open or laparoscopic appendectomy. Overlapping clinical presentations with many genitourinary and gynecological conditions lead to difficulty in accurate diagnosis, making negative appendectomies an unwanted reality. With the advancement in technology, there have been constant efforts to minimize negative appendectomy rates (NAR) using imaging modalities like USG of the abdomen and the gold-standard imaging test, the contrast-enhanced computed tomography of the abdomen. Due to the cost incurred and the lesser availability of such imaging modalities and needed expertise in resource-poor settings, various clinical scoring systems were devised to accurately diagnose acute appendicitis and thereby decrease NAR. We conducted our study to determine the NAR between the Raja Isteri Pengiran Anak Saleha Appendicitis score (RIPASA) and the modified Alvarado (MA) scoring methods. Methods A prospective observational analytical study was conducted, including 50 patients presenting to our hospital with acute appendicitis and who underwent emergency open appendectomy. The need to operate was decided by the treating surgeon. Patients were stratified by both scores; the pre-operative scores were noted and were later compared with the histopathological diagnosis. Results A total of 50 clinically diagnosed patients with acute appendicitis were evaluated utilizing the RIPASA and the MA scores. The NAR was 2% using the RIPASA score vs 10% with the MA score. The sensitivity was 94.11% vs70.58% (p<0.0001), the specificity was 93.75% vs 68.75% (p<0.0001), the positive predictive value (PPV) of 96.96% vs 82.75% (p<0.001), the negative predictive value (NPV) of 88.23% vs 52.38% (p<0.001), and NAR of 2% vs 10% (p<0.0001) in the RIPASA vs MA scoring method, respectively. Conclusions RIPASA score is highly efficacious and statistically significant in diagnosing acute appendicitis with higher PPV at higher scores and higher NPV with lower scores leading to decreased NAR compared with MA score.

An observational study on lifestyle and environmental risk factors in patients with acute appendicitis

PurposeAcute appendicitis is a common abdominal emergency worldwide. This study aimed at characterizing environmental risk factors influencing the development and severity of acute appendicitis. MethodsPatients from a Belgian acute appendicitis cohort (n = 374) and healthy controls from the 500 functional genomics (500FG) cohort (n = 513) were compared. Individuals with a history of appendectomy (n = 1067) and without a history of appendectomy (n = 8656) were available from the Nijmegen Biomedical Study (NBS). Questionnaires on demographics, lifestyle and environment were available. Binary logistic regression was used for prediction models. ResultsFifteen risk factors for developing acute appendicitis were identified. Binary logistic regression showed that 7 were independent risk factors: family history of acute appendicitis, having grown up in a rural environment, having a lower education, probiotic use as well as antibiotic use increased the risk of developing appendicitis. Fruit and fiber-rich vegetable consumption decreased the risk. Findings on vegetable consumption, smoking and level of education were replicated in the NBS population. Independent risk factors for complicated appendicitis were being male, higher age, and a delay to diagnosis of more than 48 h. ConclusionsEnvironmental exposures influence the risk of developing appendicitis. Further research into these factors is needed.

Spectrum, Management, and Outcomes of Abdominal Surgical Emergencies at a Referral Hospital in North West Cameroon

Purpose: Abdominal surgical emergencies are a major health burden in low- and middle-income countries where management is often very challenging, and associated with high morbidity and mortality. The spectrum, management, and outcomes of abdominal surgical emergencies needs to be updated.Methods: This was a hospital-based retrospective cross-sectional study carried out in Bamenda, Cameroon over a 2-year period. Records of patients who met the inclusion criteria were reviewed, with pre-, intra- and postoperative data collected and analyzed.Results: There were 207 patients included in this retrospective review (male to female ratio of 1.4:1. The mean age was 47.4 (± 19.4) years. Intestinal obstruction (34.8%) and perforated peptic ulcers (15.5%) were the most common abdominal surgical emergencies. The median delay and interquartile range to presentation and in-hospital delay were 6 (4) days and 8 (12) hours, respectively. The mean length of hospital stay post-surgery was 11days. There were 48.3% of patients who developed a complication; 34.78% were major, 17.9% had an unplanned reoperation, and 15 (7.2%) were readmitted after discharge. The 30-day in hospital mortality was 19.8%. Mortality was independently associated with a high American Society of Anesthesiologists (ASA) score; ASA score &gt; 3, age &gt; 60 years, and referral from other health facilities.Conclusion: Intestinal obstructions from intraperitoneal neoplasm is the most common cause of abdominal surgical emergency in North West Cameroon. Abdominal emergencies here are associated with a very high morbidity and mortality in males &gt; 60 years with an ASA score &gt; 3 and with more than one comorbidity.

Open Abdomen in Elderly Patients With Surgical Sepsis: Predictors of Mortality

IntroductionElderly patients are frequently presenting with emergency surgical conditions. The open abdomen technique is widely used in abdominal emergencies needing rapid control of intrabdominal contamination. However, specific predictors of mortality identifying candidates for comfort care are understudied. MethodsThe 2013-2017 the American College of Surgeons-National Surgical Quality Improvement Program database was queried for emergent laparotomies performed in geriatric patients with sepsis or septic shock in whom fascial closure was delayed. Patients with acute mesenteric ischemia were excluded. The primary outcome was 30-d mortality. Univariable analysis, followed by multivariable logistic regression, was performed. Mortality was computed for combinations of the five predictors with the highest odds ratios (OR). ResultsA total of 1399 patients were identified. The median age was 73 (69-79) y, and 54.7% were female. 30-d mortality was 50.6%. In the multivariable analysis, the most important predictors were as follows: American Society of Anesthesiologists status 5 (OR = 4.80, 95% confidence interval [CI], 1.85-12.49 P = 0.002), dialysis dependence (OR = 2.65, 95% CI 1.54-4.57, P < 0.001), congestive hearth failure (OR = 2.53, 95% CI 1.52-4.21, P < 0.001), disseminated cancer (OR = 2.61, 95% CI 1.55-4.38, P < 0.001), and preoperative platelet count of <100,000 cells/μL (OR = 1.87, 95% CI 1.15-3.04, P = 0.011). The presence of two or more of these factors resulted in over 80% mortality. The absence of all these risk factors results in a survival rate of 62.1%. ConclusionsIn elderly patients, surgical sepsis or septic shock requiring an open abdomen for surgical management is highly lethal. The presence of several combinations of preoperative comorbidities is associated with a poor prognosis and can identify patients who can benefit from timely initiation of palliative care.

Lollipop stick en-route cecum: Mimic of appendicitis

Acute appendicitis is commonly encountered abdominal emergency in children which present clinically with acute onset right iliac fossa pain. We present a case by a 5-year-old child which presented in a similar manner, however, was subsequently diagnosed with perforation in cecum secondary to foreign body ingestion on contrast-enhanced computed tomography.

PIMS - symptoms and short/long-term gastrointestinal and cardiovascular system complications

PIMS (paediatric inflammatory multisystem syndrome associated with COVID-19 or Multisystem Inflammatory Syndrome in Children (MIS-C)) is a new disease classification, occurring in children and young adults associated with the SARS-CoV-2 infection. Although children suffer from COVID-19 infection asymptomatically or mildly, long-term complications of the disease may be more severe for them than for adults. Despite the fact that PIMS is a relatively new disease, we already know that it should not be underestimated. In spite of the clinical picture of these complications may resemble Kawasaki Disease (KD), we may notice some differences in laboratory tests (such as reduced number of lymphocytes, decreased platelet count or elevated ferritin levels). Although usually the first symptom of PIMS is high fever, it is followed by symptoms related to the digestive system, present in about 80% of cases. The insidious and severe gastrointestinal symptoms of PIMS can mimic abdominal surgical emergencies, including acute appendicitis, gastrointestinal infections or inflammatory bowel disease. Cardiovascular symptoms occur in approximately 60% of patients with PIMS. Immunomodulatory therapy plays an essential role in the treatment of PIMS. The exact causes of PIMS are recently unknown, however, it is explained as genetic hyperactivation of immunity. In this minireview we summarize the most recent data about this condition, mainly we are focusing on gastrointestinal and cardiovascular symptoms, short/long-term complications and treatment.