DOI: http://dx.doi.org/10.18203/2349-2902.isj20214013

Abdominal emergency related to retro and intraperitoneal lesions caused by COVID-19

Noureddine Njoumi, Jalal Kasouati, Aziz Zentar, Abdelmounaim Ait Ali

Abstract


Digestive manifestations accompanying or preceding respiratory symptoms of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) are frequent and appears to be associated with its most severe forms. In contrast, isolated digestive involvement in covid-19 is rare and misdiagnosed. It was found that nausea/vomiting, diarrhea, abdominal pain and loss of appetite are the main recognized digestive disorders in patients infected by SARS-COV-2. Acute abdomen with occlusive syndrome has never been reported in the literature to our knowledge. We report the case of a 60-year-old woman who was presented with an occlusive syndrome related to retro and intraperitoneal lesions caused by Covid-19 infection without any respiratory manifestations. She underwent an emergency surgery. The paucity of data about this unusual clinical presentation posed a serious diagnostic and therapeutic challenge.


Keywords


COVID-19 infection, Emergency, Retroperitoneal hemorrhage, Acute abdomen, Occlusive syndrome

Full Text:

PDF

References


Chunxiang M, Yingzi C, Hu Z. COVID-19 and the Digestive System. Am J Gastroenterol. 2020;00:1-4.

Alharthy A, Balhamar A, Faqihi F, Nasim N, Noor AF, Alqahtani SA et al. Rare case of COVID-19 presenting as acute abdomen and sepsis. New Microbes New Infect. 2020;38:100818.

Guan W, Ni Z, Hu Y, Liang WH, Ou CQ, He JX et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;NEJMoa2002032.

Lei P, Mi M, Pengcheng Y, Yu S, Runsheng W, Junhong Y, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115(5):766-73.

Hunt RH, East JE, Lanas A, Malfertheiner P, Satsangi J, Scarpignato C et al. COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist. Dig Dis. 2020 ;1-21.

Mao R, Qiu Y, He JS, Tan JY, Li WH, Liang J et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(7):667-78.

Tian Y, Rong L, Nian W, He Y. Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther. 2020;51(9):843-51.

Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020;5:428-30.

Wander P, Epstein M, Bernstein D. COVID-19 presenting as acute hepatitis. Am J Gastroenterol. 2020;115(6):941-2.

Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, et al. The digestive system is a potential route of 2019-nCov infection: A bioinformatics analysis based on single-cell transcriptomes. bioRxiv. 2020.

Tay MZ, Poh CM, Renia L, MacAry PA, Ng LF. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363-74.

Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Transplant. 2020;39(5):405-7.

Menter T, Haslbauer JD, Nienhold R, Savic S, Hopfer H, Deigendesch N, et al. Post‐mortem examination of COVID19 patients reveals dif¬fuse alveolar damage with severe capillary congestion and variegated findings of lungs and other organs suggesting vascular dysfunction. Histopathology. 2020;77(2):198-209.

Scialpi M, Sara S, Piscioli I, Scalera GB, Longo F. Pulmonary thromboembolism in critical ill COVID-19 patients. Int J Infect Dis. 2020;95:361-2.

Erika P, Domenica Z, Paolo I, Luca R, Giulia L, Alessandro D et al. Lactate dehydrogenase and C-reactive protein as predictors of respiratory failure in CoVID-19 patients. Clin Chim Acta. 2020;509:135-8.

Ahmed OE A, Badawi M, Ahmed K, Mohamed MFH. Case Report: COVID-19 Masquerading as an Acute Surgical Abdomen. Am J Trop Med Hyg. 2020;103(2):841-3.

Ahmed K, Mohamed MFH. Acute abdomen is not always surgical amid the COVID-19 pandemic. Br J Surg. 2020;107(10):e434-5.

Cao B, Wang Y, Wen D. A trial of Lopinavir-Ritonavir in adults hospitalized with severe Covid-19. N Engl J Med. 2020;382:1787-99.

Su S, Shen J, Zhu L, Qiu Y, He JS, Tan JY et al. Involvement of digestive system in COVID-19: manifestations, pathology, management and challenges. Ther Adv Gastroenterol. 2020;13:1-12.