A case report on spontaneous hemoperitoneum in COVID-19 patient

Karki, Saurab; Rawal, Sushil Bahadur; Malla, Srijan; Rayamajhi, Jyoti; Thapa, Bikash Bikram

doi:10.1016/j.ijscr.2020.09.078

Cited by 23 publications

(30 citation statements)

References 18 publications

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“…Finally, this case series besides other intraperitoneal bleeding reports in COVID-19 patients [10,11,20,21] demonstrated that COVID-19 coagulopathy and AT should be studied more. To reduce the disease mortality and morbidity investigations on the pathophysiology of COVID-19-associated coagulopathy and finding the best intervention to prevent or treat it is needed.…”

Section: Discussionsupporting

confidence: 53%

Massive intraperitoneal hemorrhage in patients with COVID-19: a case series

Reisi-Vanani

Lorigooini

Dayani

et al. 2021

J Thromb Thrombolysis

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Coronavirus disease (COVID-19) initiates several life-threatening complications including coagulopathies with a unique characteristic that made this problem challenging. Here we presented 4 cases of RT-PCR positive patients that have experienced deadly intraperitoneal hemorrhage with fourth WHO Bleeding Grade after overcoming their respiratory phase. COVID-19 could induce several coagulopathies with different features that besides iatrogenic interventions increases its mortality and morbidity due to lack of clinical evidence based on well-designed randomized clinical trials on anticoagulation therapies (AT) and administration of varieties of newly approved and non-approved medicines. This report showed the urgent need for investigation on the pathophysiology of COVID-19-associated coagulopathy esp. in hemorrhagic events which are needed to make the best therapeutic decision.

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Section: Discussionsupporting

confidence: 53%

Massive intraperitoneal hemorrhage in patients with COVID-19: a case series

Reisi-Vanani

Lorigooini

Dayani

et al. 2021

J Thromb Thrombolysis

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“…This marks one of the major differences between SARS-CoV-2-related splenic ruptures and other infectious and hematologic etiologiesthese result in splenomegaly in approximately 55% of cases [17]. Several case reports on spontaneous splenic rupture in patients with SARS-CoV-2 [17,18] as well as splenic thromboembolic disease have surfaced within the last year [4,[19][20][21]. We present a case of an elderly woman whose initial COVID-19 presentation at the hospital involved atraumatic/spontaneous splenic rupture in the absence of respiratory symptoms.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 With an Initial Presentation of Intraperitoneal Hemorrhage Secondary to Spontaneous Splenic Rupture

Knefati¹,

Ganim²,

Schmidt³

et al. 2021

Cureus

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The WHO declared coronavirus disease 2019 (COVID-19) a global pandemic in early 2020. As the pandemic has continued to evolve over a period of several months, many cases of unusual presentations are now emerging, which pose a greater challenge for physicians in terms of quickly identifying COVID-19 patients based on initial signs and symptoms. In this report, we present one such unusual presentation in a patient with sudden intraperitoneal hemorrhage and spontaneous splenic rupture with COVID-19 as the likely etiology and contributing factor.The patient was a 75-year-old Caucasian woman who presented to the emergency department (ED) with complaints of severe left-sided abdominal pain for several days without any preceding trauma. A CT of the abdomen/pelvis revealed a large amount of fluid in the abdomen, which raised suspicion of bleeding. An exploratory laparotomy revealed splenic rupture with hemoperitoneum, and the patient subsequently underwent an emergent splenectomy. The patient's COVID-19 antigen test returned positive during the surgery and was subsequently confirmed with a polymerase chain reaction (PCR) test.COVID-19 has been found to result primarily in respiratory symptoms through its ability to invade endothelial cells via angiotensin-converting enzyme 2 affinity. It is speculated that this mechanism may cause a predisposition to micro-thromboses, which can eventually lead to manifestations such as large lymphoid organ thrombosis. Based on this case presentation and the evolving literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spontaneous splenic rupture is an emergent differential diagnosis that should be considered in COVID-19 patients presenting with gastrointestinal complaints such as abdominal pain and nausea.

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“…Severe acute respiratory syndrome (SARS) coronavirus-(CoV-) 2 (SARS-CoV-2), the etiological agent that causes coronavirus disease 2019 (COVID- 19), which was declared a pandemic by the World Health Organization (WHO) in March 2020, presents principally as a lower respiratory tract infection, but the multisystemic nature of the disease is evident in severe cases. Indeed, a broad spectrum of symptoms associated with COVID-19 has been identified.…”

Section: Introductionmentioning

confidence: 99%

Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

Agus

Ferrara

Bianco

et al. 2021

Case Reports in Surgery

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Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.

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A case report on spontaneous hemoperitoneum in COVID-19 patient

Abstract: Highlights Young adult COVID-19 patient presented with acute abdomen. Evaluation of patient revealed splenomegaly, splenic rupture and hemoperitoneum. Patient recover with conservative management.

Cited by 23 publications

References 18 publications

Massive intraperitoneal hemorrhage in patients with COVID-19: a case series

Massive intraperitoneal hemorrhage in patients with COVID-19: a case series

COVID-19 With an Initial Presentation of Intraperitoneal Hemorrhage Secondary to Spontaneous Splenic Rupture

Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

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