Acute appendicitis and pediatric multi-system inflammatory syndrome overlap

Aim. Our aim was to present acute appendicitis cases with pediatric multi-system inflammatory syndrome (MIS-C), how to spot MIS-C and how to treat it. Materials and methods. We analyzed 6 patients, admitted to the Pediatric Surgery Department at the Hospital of Lithuanian University of Health Sciences from 2021 January 7th to March 23rd with acute appendicitis, who were later confirmed to have MIS-C. Results. All were treated with antibiotics and five were operated. All patients were found to have a deteriorating condition and increase in inflammatory markers despite treatment and were found to have MIS-C, with all of them having positive Immunoglobulin G for SARS-CoV-2. Conclusion. During the COVID-19 pandemic, even with clear signs of acute appendicitis, MIS-C must be considered in children with known recent exposure to COVID-19 or in patients where surgical and antibiotic treatment does not improve the condition and other organ system involvement is noticed.