A Rare Structural Cause of Pediatric Small Bowel Obstruction Identified During COVID-19 Infection: Case Report

Small bowel obstruction in children may result from diverse etiologies, and timely intervention is critical for identifying the underlying mechanism. This report discusses a pediatric patient with progressive gastrointestinal symptoms such as vomiting, abdominal discomfort, fever, and persistent constipation, over a period of two weeks. Dilated bowel loops were observed on imaging, and the obstruction persisted despite the contrast challenge. Surgical exploration revealed a partial intussusception of the terminal ileum with an ileal duplication, necessitating segmental resection. The child tested positive for COVID-19 during the initial evaluation. The duplication cyst in this case served as the anatomical lead point, and the concurrent viral infection posed a diagnostic challenge due to the overlapping presence of mechanical and inflammatory symptoms. This case underscores the necessity for a broader differential diagnosis in the pediatric population presenting with bowel obstruction, especially when symptoms are accompanied by systemic infections or progress gradually. Prompt recognition of these overlapping clinical presentations will aid in the early identification and management of surgically significant pathologies.