ABSTRACT
There is no definitive guideline to distinguish multisystem inflammatory syndrome in children (MIS-C) associated with gastrointestinal symptoms from surgically-based pathologies such as volvulus. A 9-year-old boy presented with periumbilical abdominal pain and non-bilious vomiting. A week prior, he and his family had fever. He arrived at the emergency department dehydrated and in shock. His abdomen was soft, non-tender and non-distended. Abdominal x-ray showed faecal loading and no dilated bowel while ultrasound showed features of enterocolitis. The polymerase chain reaction was positive for SARS-CoV-2. He was treated for MIS-C and intravenous immunoglobulin and methylprednisolone were administered. Later, there was progressive abdominal distention where CT angiography of abdomen demonstrated ascites and generalized small bowel dilatation and thickening. Exploratory laparotomy found small bowel volvulus and anomalous bands (AB). SARS-CoV- 2 has been speculated to trigger dysregulation of the immune response resulting in multiorgan failure. Around 68.3% - 73.7% of MIS-C patients had gastrointestinal symptoms. Small bowel obstruction secondary to AB is a rare entity contributing only about 3% of the total cases2. AB may be acquired as a result of an infection or inflammatory condition, or it may be congenital. The diagnosis of obstructed congenital AB was based on the exclusion of acquired cause 3. Recent SARS-CoV-2 infection may have contributed to this patient's condition. As immunomodulatory therapies are required, it is crucial to consider MIS-C in the diagnostic process. This case illustrates the complexity in attaining a diagnosis. COVID-19 can cause a myriad of inflammatory dysregulation which in turn, present as a multitude of symptoms. Physicians in all time should always think of other possible causes of the symptoms to ensure the best course of management for the patient.
ABSTRACT
Quarantine place perimeter breach COVID-19 patients that required to do self-isolate and self-quarantine from public is usually occur when the patient is not following the SOP and regulations drawn by government. This will lead to possibly spread of the COVID-19 virus into the community. These persons need to be closely monitored their movement or location online in order to prevent further spread of COVID-19 to public within their surrounding area. In view of this situation, the research project proposed to develop Quarantine Perimeter Breach Monitoring System (QPBMS) that can detect and alert the authority when the COVID-19 patient commit the offence of perimeter breach from their isolation place. A smartphone GPS and HERE Tracker apps are used in the system for the detection and notification alert. The impact of this monitoring system will enable authority or health official to locate and closely monitored the COVID-19 adhered to their self-isolation period. With the accurate and stable tracing of the HERE tracker, the health officer law enforcer can be notified with a precise info about any quarantine period violation. © 2022 IEEE.