Traumatic jejunal perforation associated with SARS-CoV-2 (COVID-19) infection

Abstract

Several case reports have suggested that COVID-19 may increase the risk of gastrointestinal perforation. We report a case of a gastrointestinal perforation developing in a COVID-19 patient who presented due to injuries from a motor vehicle accident. On admission, the patient had elevated white blood cells, with neutrophilia and lymphopenia. Histological examination of tissue surrounding the perforation revealed extensive infiltration of lymphocytes and plasma cells into the intestinal mucosa. These findings are consistent with SARS-CoV-2 infection. However, further pathophysiological studies are needed to assess the mechanisms by which COVID-19 may damage the gastrointestinal mucosa leading to gastrointestinal perforation. KEYWORDS COVID-19; gastrointestinal; jejunum; perforation; trauma P atients with the novel coronavirus known as SARS-CoV-2/COVID-19 may present with various respiratory, musculoskeletal, gastrointestinal, hepatic, cardiovascular, and neurologic diseases. 1 Gastrointestinal symptoms, including nausea, diarrhea, anorexia, abdominal pain, belching, and emesis, can occur in up to 50% of COVID-19 patients. 1 However, several case reports have suggested a potential role of COVID-19 in causing gastrointestinal perforations. [2][3][4][5][6][7][8][9] We report a case of a gastrointestinal perforation in a COVID-19 patient developing after a motor vehicle accident.

Isolated jejunal perforation - hidden danger in blunt abdominal trauma

“…There is still no consensus in the literature regarding the effects of delayed surgical treatment of traumatic small intestine perforation, but it is generally accepted that morbidity and mortality is significantly lower in the case of early diagnosis and emergency surgical treatment [21,22] Mingoli and colleagues found that leukocytosis and delayed treatment (>6 hours) are independent predictors of postoperative morbidity [26].…”