Evaluation of acute terminal ileitis in children before and during the COVID-19 pandemic

Abstract

ObjectivesThe aim of this study was to examine the clinical features of acute terminal ileitis in children and evaluate its rate before and during the COVID-19 pandemic.MethodsThis retrospective study was performed in our pediatric emergency department between 2018 and 2022. The records of 5363 patients who required abdominal imaging due to acute abdomen were analyzed, and 143 patients with terminal ileitis were included. The rate and etiological causes were compared during and before the COVID-19 pandemic.ResultsThe rate of acute terminal ileitis has increased over the years. The fastest increase was in 2021, when the COVID-19 pandemic was experienced. While 59 (41.2%) patients showed acute nonspecific ileitis, the most common etiologic cause that could be identified was acute gastroenteritis. It was determined that multisystem inflammatory syndrome in children was among the causes of ileitis after the COVID-19 pandemic and was one of the top three causes.ConclusionsAcute terminal ileitis, which has many etiologies, is one of the rare radiological findings in acute abdominal pain. Examination and laboratory findings are not specific. Guidelines are needed for the investigation of the underlying etiology of acute terminal ileitis in children. The incidence of acute terminal ileitis is increasing, and the increase has been found to be faster after the COVID-19 pandemic. What is Known COVID-19 frequently affects the gastrointestinal system, particularly in children. COVID-19 may cause ATI with more severe clinical findings, especially in Multisystem inflammatory syndrome in children (MIS-C). There are very limited publications on acute terminal ileitis (ATI) in children. It is difficult to identify the etiologic cause.What is New The rate of acute terminal ileitis has increased over the years. The fastest increase was in 2021, when the COVID-19 pandemic was experienced. MIS-C and familial Mediterranean fever should be considered in the etiology of ATI in the differential diagnosis of acute abdomen.