No abstract

No abstract

As the coronavirus disease 2019 (COVID-19) pandemic is still underway, a range of clinical presentations and pathologies continue to present themselves in unexpected ways. One such pathology is that of epiploic appendagitis, an uncommon and underdiagnosed cause of acute abdominal pain. We present the case of a 50-something-year-old male who presented with left lower quadrant abdominal pain in the setting of acute COVID-19 infection, found to have acute epiploic appendagitis. After persistent moderate to severe abdominal pain, epiploic appendagitis was diagnosed by computed tomography (CT) imaging findings. The patient was managed for his COVID-19 pneumonia over the course of his hospitalization, as well as conservatively managed with pain control measures for his epiploic appendagitis. This is the second reported case in the literature to the best of our knowledge that shares the case of acute epiploic appendagitis in a patient presenting with acute abdominal pain, who is also found to be COVID-19-positive. Procoagulant changes in coagulation pathways are found in patients with severe COVID-19, and contribute to venous thromboembolism in this patient population. Diagnosing and conservatively managing epiploic appendagitis will lead to decreasing misdiagnosis, preventing invasive or inappropriate treatments that may increase harm to patients, and more adequately understanding the complications associated with COVID-19.

Bronchopulmonary sequestration (BPS) is a congenital abnormality wherein a residual mass of nonfunctioning lung tissue exists within the thorax, with blood supply from the systemic circulation. The two main types are extralobar (EPS) and intralobar (IPS) pulmonary sequestration. IPS is often detected later in life, constitutes 75% of BPS, lacks its own visceral pleura, and is located within a normal lung lobe. One theory of pathogenesis describes formation of excess lung tissue prior to separation of pulmonary and systemic circulations. 50% of adults with IPS are asymptomatic; others may present with recurrent pulmonary infections, exertional dyspnea, hemoptysis, cough, or back pain. Diagnosis is made with CT angiogram, with the primary goal of establishing blood supply originating from systemic vasculature.

No abstract