Dilemma of Surgical Abdomen with Pulmonary Infiltrates on Chest Radiograph: Suspected Cases in COVID-19 Pandemic

Abstract

We report two cases of children presenting with surgical abdomen who had no respiratory symptoms and their chest x-ray revealed bilateral infiltrations, findings seen in patients suffering from Covid 19, despite having negative or inconclusive COVID 19 PCR report. The median time from onset of illness to diagnosis was 2 days. Both patients were explored with the provisional diagnosis of peritonitis and per-operative findings showed that one child had sub-hepatic abscess and the other had duodenal perforation. Postoperatively, both children needed ventilation and support. Child with sub-hepatic abscess expired. The purpose for this case report is to reveal the possibility of unusual abdominal features and extra pulmonary presentation of COVID 19 in children, even when tests are negative or inconclusive.