Case Report of a Paralytic Ileus in a Non-Critically ill Child with Covid 19 Infection

COVID-19 infection presents with a range of clinical manifestations, from pulmonary symptoms to multisystem organ involvement. Gastrointestinal complications, while commonly reported in adults and critically ill individuals, are not frequently seen in the pediatric population. This case report discusses a 4-year-old boy who developed abdominal distension during the course of an acute COVID-19 infection. Radiological findings were consistent with paralytic ileus. The child had a history of end-stage renal disease secondary to steroid-resistant nephrotic syndrome and had undergone a living kidney transplant eight months prior. He presented with fever, upper respiratory tract symptoms, abdominal pain, and vomiting. Despite not appearing clinically ill, his abdomen was significantly distended. An abdominal X-ray revealed dilated small bowel loops and multiple air-fluid levels. He was managed conservatively as a case of paralytic ileus. This report suggests a possible association between COVID-19 infection and the development of paralytic ileus in non-critically ill patients. We emphasize the importance of anticipating gastrointestinal complications in clinically stable patients with COVID-19 infection.