COVID-19–Related Intussusception: A Case Series and Review of the Literature

Abstract

Background:

Ileocolic intussusception is a common gastrointestinal emergency that occurs in infancy. Many cases are caused by anatomic lead points, such as hypertrophied Peyer's patches. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), commonly presents with respiratory symptoms, however, its relation to intussusception remains unknown.

Methods:

Two cases are reported as well as a review of pertinent English-language literature on the topic.

Results:

We present two cases of intussusception in COVID-19–positive patients, including the first known case of a lead point with tissue polymerase chain reaction (PCR) confirming COVID-19 positivity, and compare these findings to a review of the recent literature. Intussusception in COVID-19–positive patients is becoming more prevalent and more often requires operative treatment.

Discussion:

We offer evidence that intussusception can be the presenting symptom in the absence of COVID-19–related respiratory symptoms. There also seems to be a trend toward the need for operative intervention compared with COVID-19–negative intussusception. The presence of SARS-CoV-2 can be confirmed via PCR in specific lead points (lymph nodes), directly causing the intussusception.

Conclusions:

Providers should have a low threshold to suspect and diagnose intussusception as operative treatment is more readily used in COVID-19–positive pediatric patients with gastrointestinal symptoms.