Covid-19 mimicking symptoms in emergency gastrointestinal surgery cases during pandemic: A case series

Handaya, Adeodatus Yuda; Andrew, Joshua; Hanif, Ahmad Shafa; Fauzi, Aditya Rifqi

doi:10.1016/j.ijscr.2020.10.064

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Thrombotic complications usually presented as deep vein thrombosis, pulmonary embolism, acute coronary syndrome and stroke while mucormycosis was usually seen in the paranasal sinus extending into the orbit, mouth, face or brain and in lungs [1,2]. Acute mesenteric ischemia secondary to coronavirus-19 is rare [3][4][5] and that too due to mesenteric mucormycosis has not yet been reported in Indian literature to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 Gastrointestinal Invasive Mucormycosis

Jain¹,

Tyagi²,

Tyagi³

et al. 2021

Indian J Surg

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Thrombo-embolic episodes and invasive mucormycosis (IM) have shown a sudden surge after the second wave of novel coronavirus infection in India. Acute mesenteric ischemia secondary to coronavirus-19 is rare and that too due to invasive mesenteric mucormycosis has not yet been reported in Indian literature. We present a case of post-COVID diabetic woman who was on steroids and had mesenteric thrombosis with IM. The disease is associated with high mortality. Treatment of choice is wide surgical resection and iv liposomal amphotericin B. Since the pre-operative as well as intra-operative diagnosis is difficult, high index of suspicion for IM is necessary in post-COVID-19 patients presenting with mesenteric ischemia or bowel perforation.

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Section: Discussionmentioning

confidence: 99%

Post-COVID-19 Gastrointestinal Invasive Mucormycosis

Jain¹,

Tyagi²,

Tyagi³

et al. 2021

Indian J Surg

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“…It has been reported that the virus can bind with Angiotensin-converting enzyme 2 (ACE2) receptors in the intestine, which makes the intestine susceptible to inflammation resulting in common symptoms such as diarrhea, nausea, vomiting, anorexia, or abdominal pain. Therefore, surgeries for intra-abdominal diseases require strict screening and tight protocol to minimize the risk of transmission of COVID-19 [ 4 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Management of gallstone-induced severe acute cholecystitis and pancreatitis in the second trimester of pregnancy during covid-19 pandemic: A case report

Handaya

Fauzi

Andrew

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be life-threatening both for the mother and fetus. Surgical approach is recommended in this complicated disease to prevent morbidity and mortality. During COVID-19 pandemic, additional precautions are needed when dealing with abdominal complaints. Presentation of case We present a 37-year-old female patient, pregnant at 22 weeks gestational age, who complained of fever, diffuse abdominal pain, and shortness of breath. Laboratory examination results revealed anemia, leukocytosis and an increase in amylase level. SARS-CoV-2 antibody is non-reactive. Imaging strongly suggested cholelithiasis and cholecystitis. The patient was given antibiotics for three days but there was no significant improvement. Open cholecystectomy with subcostal (Kocher) incision was performed. Patient was released from the hospital without post-operative complications. Discussion Treatment of gallstone induced severe acute cholecystitis with acute pancreatitis during pregnancy is challenging with the surgical complications. In the second and third trimester of pregnancy, it is more difficult to perform laparoscopic cholecystectomy because of the size of uterus. Laparoscopic procedure is also not recommended in early Covid-19 pandemic period. Therefore, open cholecystectomy with Kocher incision becomes the surgery of choice to avoid preterm birth. Conclusions Based on our case, open cholecystectomy with Kocher incision is a safe and effective procedure for pregnant patients with cholelithiasis, cholecystitis, and pancreatitis.

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“…The likelihood of detecting the virus RNA was higher in patient who presented with diarrhea. [11] Angiotensin converting enzyme 2 (ACE2) receptor was identified to be the entry point of SARS-CoV to the epithelial cells in the respiratory system and enterocyte in the gastrointestinal system. ACE2 found abundantly in type 2 pneumocytes in the lung, intestinal mucosa and to lesser extent in the liver and biliary tree.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Associated Spontaneous Bowel Perforation

Alkatary¹,

Zarooni²,

Harthi³

2021

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The purpose of this article is to report on the newly recognized life threating gastrointestinal complications of Corona virus infection in the form of bowel ischemia and ischemic bowel perforation. In a retrospective observational study at Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, United Arab Emirates during the period between March and May 2020. All COVID-19 positive patients with free intra peritoneal air were included; total of five patients met our inclusion criteria during the study period, all patients were admitted to the intensive care unit for mechanical ventilation and management of severe COVID 19 related respiratory complications. COVID-19 status was based on a positive PCR nasopharyngeal swab supported by typical radiological findings on either chest X-ray (CXR) or CT Chest. Free air under the diaphragm was radiologically confirmed in all patients. Patients' demographics and co-morbidities were reviewed. Four patients underwent an emergency surgical intervention confirming ischemic perforation of the right colon. The caecum was identified as the starting point of ischemia with variable distal extension into the ascending colon and the hepatic flexure. One patient unfortunately demised prior to surgery due to severe septic complications. These findings highlight the importance of paying attention to COVID 19 patients with sudden clinical deterioration and raise the extent of the gastrointestinal manifestation of COVID-19 infection beyond simple diarrhea and abdominal pain.

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Covid-19 mimicking symptoms in emergency gastrointestinal surgery cases during pandemic: A case series

Abstract: Highlights Digestive surgery emergency cases can present with COVID-19 mimicking symptoms Indications of emergency surgery are the same in during pandemic compared to non-pandemic settings Strict screening, examination, and protocol are necessary during pandemic

Cited by 4 publications

References 9 publications

Post-COVID-19 Gastrointestinal Invasive Mucormycosis

Post-COVID-19 Gastrointestinal Invasive Mucormycosis

Management of gallstone-induced severe acute cholecystitis and pancreatitis in the second trimester of pregnancy during covid-19 pandemic: A case report

COVID-19 Associated Spontaneous Bowel Perforation

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