Most patients with coronavirus disease 2019 (COVID-19) present with respiratory symptoms that range from mild symptoms to severe illness leading to mortality. Some might be asymptomatic and others may present with unusual presentations. A 55-year-old male with a past history of ischemic stroke, ischemic heart disease, and type 2 diabetes mellitus presented with right-sided weakness and a history of abdominal pain, diarrhea, and fever. He tested positive for COVID-19. Computed tomography (CT) abdomen showed the presence of splenic abscess and small intraperitoneal gas indicating pneumoperitoneum. Laparotomy revealed ruptured splenic abscess and splenectomy was done. The patient continued to show features of severe sepsis with multiorgan failure and died on postoperative day 16. COVID-19 mainly affects the respiratory system but extrapulmonary affection has been reported. Direct invasion and damage to the organs by the virus could be the reason behind the development of the extrapulmonary manifestations.

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Splenic abscess is an aggressive disease with a non-specific etiology and symptoms that are systemically detrimental. During the current COVID-19 pandemic, there has been a noted rise in the incidence of splenic abscesses. The aim of this article was to explore whether infection with the SARS-CoV-2 virus increases the risk of developing splenic abscesses. We reviewed three cases with SARS-CoV-2 infection who developed splenic abscess. The clinical characteristics, treatment course, management and outcome are reported. We perceived that hypercoagulability status, superimposing infections and immunosuppression were related to SARS-CoV-2 infection. These were common factors in these three observed cases of splenic abscess as a complication related to the new viral pandemic. SARS-CoV-2 infection might be a risk factor in development of splenic abscess. SIMILAR CASES PUBLISHED: To the best of our knowledge only one case similar to our case series was published.

Key Clinical MessageBlunt abdominal trauma is a rare case of intestinal obstruction, and only few cases have been reported in the world literature. Stenotic intestinal obstruction following blunt abdominal trauma is a very rare complication. This case highlights the need for clinical suspicion serial clinical assessment and radiological evaluation and the need for early surgery in patients presenting with abdominal symptoms following blunt abdominal trauma.