scholarly journals 26 COVID-19 Diagnosis in Patients with Acute Abdominal Pain Without Respiratory Symptoms: A UK Emergency General Surgical Unit Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Zuberi ◽  
Y Mushtaq ◽  
K Patel ◽  
S Vickramarajah ◽  
A Askari ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Acute Abdominal Pain ◽  
Rt Pcr ◽  
Thoracic Imaging ◽  
Atypical Symptoms ◽  
Thoracic Ct ◽  
Surgical Unit ◽  
Positive Half

Abstract Introduction Evidence has emerged reporting atypical symptoms of the coronavirus (COVID-19). There is a sparsity of existing studies examining COVID-19 related abdominal pain and the role of investigative imaging for the virus in these patients. Study aims were to determine COVID-19 incidence in those with acute abdominal pain in the absence of respiratory symptoms and to assess the performance of Computer Tomography (CT) thoracic imaging. Method Retrospective analysis of all patients admitted to our emergency general surgical unit between 1st March 2020 and 31st May 2020 was performed. All patients underwent nasal and oro-pharyngeal COVID-19 RT-PCR swabs as well as CT on admission. Results From 112 patients admitted with acute abdominal pain in the absence of respiratory symptoms, 16 (14.3%) tested positive for COVID-19 on RT-PCR swab testing. 50% (8/16) of these patients had no intra-abdominal pathology on CT. The sensitivity and specificity of CT thoracic imaging for COVID-19 was 43.8% and 91.7%. Conclusions One in seven patients with abdominal pain without any respiratory symptoms tested positive. Half these patients represented COVID-19 manifesting primarily as acute abdominal pain. Combined swab testing and CT imaging should be performed in all abdominal pain presentations due to the varying diagnostic performance of thoracic CT in diagnosing COVID-19.

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

The role of ultrasonography in the diagnosis and management of non-traumatic acute abdominal pain

2008 ◽  
Vol 3 (4) ◽  
pp. 349-354 ◽  
Author(s):  
Mehmet Selim Nural ◽  
Meltem Ceyhan ◽  
Ahmet Baydin ◽  
Selim Genc ◽  
Ilkay Koray Bayrak ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Diagnosis And Management

scholarly journals Incidentally Discovered COVID-19 in Low Suspicion Patients

2020 ◽  
Author(s):  
Nicholas Xiao ◽  
Samir Abboud ◽  
Danielle M McCarthy ◽  
Nishant Parekh
Keyword(s):  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
International Travel ◽  
Imaging Findings ◽  
Rt Pcr ◽  
Abdominal Ct ◽  
Clinical Criteria ◽  
Time Of Presentation ◽  
Current Paradigm

Abstract PurposeThe COVID-19 pandemic has been responsible for thousands of deaths worldwide. Testing remains at a premium, and criteria for testing remains reserved for those with lower respiratory infection symptoms and/or a known high-risk exposure. The role of imaging in COVID-19 is rapidly evolving, however few algorithms include imaging criteria, and it is unclear what should be done in low-suspicion patients with positive imaging findings.MethodsFrom 03/01/2020-03/20/2020, a retrospective review of all patients with suspected COVID-19 on imaging was performed. Imaging was interpreted by a board-certified, fellowship trained radiologist. Patients were excluded if COVID-19 infection was suspected at the time of presentation, was the reason for imaging, or if any lower respiratory symptoms were present.ResultsEight patients with suspected COVID-19 infection on imaging were encountered. Seven patients received testing due to suspicious imaging findings with subsequent lab-confirmed COVID-19. No patients endorsed prior exposure to COVID-19, or recent international travel. COVID-19 was suggested in six patients incidentally on abdominal CT and two on chest radiography. At the time of presentation, no patients were febrile and seven endorsed gastrointestinal symptoms. Five COVID-19 patients eventually developed respiratory symptoms and required intubation. Two patients expired during the admission.ConclusionsPatients with imaging findings suspicious for COVID-19 warrant prompt RT-PCR testing even in low clinical suspicion cases. The prevalence of disease in the population may be underestimated by the current paradigm of RT-PCR testing with the current clinical criteria of lower respiratory symptoms and exposure risk.

scholarly journals Missed Diagnosis of Cholangiocarcinoma Presenting with Atypical Symptoms

2021 ◽  
Author(s):  
Ren Kawamura ◽  
Yukinori Harada ◽  
Taro Shimizu
Keyword(s):  
Abdominal Pain ◽  
Distribution Pattern ◽  
Diagnostic Test ◽  
Acute Abdominal Pain ◽  
Delayed Diagnosis ◽  
Referred Pain ◽  
Good Communication ◽  
Atypical Symptoms ◽  
Missed Diagnosis ◽  
Prompt Diagnosis

We report a case of delayed diagnosis of cholangiocarcinoma. A 62-year-old man developed acute abdominal pain in multiple sites. As the distribution pattern of the abdominal pain was not correctly interpreted based on the mechanisms of visceral and referred pain, the patient was not investigated with the best diagnostic test at first presentation. Moreover, miscommunication between physicians in a clinic and separate hospital delayed diagnosis. For prompt diagnosis, physicians should be practice careful reasoning and focus on good communication with physicians outside their hospital.

The role of emergency MRI in the setting of acute abdominal pain

2014 ◽  
Vol 21 (6) ◽  
pp. 615-624 ◽  
Author(s):  
Noah G. Ditkofsky ◽  
Ajay Singh ◽  
Laura Avery ◽  
Robert A. Novelline
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain

scholarly journals A challenging case of COVID-19 infection presented with isolated acute abdominal pain: A case report and literature review

2021 ◽  
Vol 9 ◽  
pp. 2050313X2098321
Author(s):  
Mohammad Altermanini ◽  
Mhd Baraa Habib ◽  
Abdel-Naser Elzouki
Keyword(s):  
Infectious Disease ◽  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Respiratory Symptoms ◽  
Acute Abdominal Pain ◽  
Gastrointestinal Symptoms

COVID-19 is an infectious disease, which often presents with fever and respiratory symptoms. However, gastrointestinal symptoms have also been reported to occur in patients with COVID-19. Although abdominal pain was described in some reports of COVID-19, it was uncommon and often associated with other symptoms. We describe a challenging case of a COVID-19 patient who presented with severe isolated abdominal pain initially, then developed pneumonia symptoms which led to the diagnosis of COVID-19 thereafter.

scholarly journals CHEST IMAGING FOR EARLY DIAGNOSIS OF COVID-19 ON A PATIENT WITHOUT RESPIRATORY SYMPTOMS: A CASE REPORT

2020 ◽  
Vol 5 (2) ◽  
pp. 80
Author(s):  
Wahyu Widiastana ◽  
Teguh Kristian Perdamaian ◽  
Sutaryanu Dermoredjo
Keyword(s):  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Atypical Presentation ◽  
Case Description ◽  
Chest Imaging ◽  
Infected Person ◽  
Rt Pcr ◽  
Risk Patients ◽  
Loss Of Appetite

Background: The Coronavirus 2019 disease (COVID-19) is transmitted through droplet and aerosol from the respiratory tract of an infected person; and fomites from infected linen and surface. On August 1, 2020, in Yogyakarta, there were 741 confirmed positive cases of COVID-19, and it is still possible to increase. In the time of understanding COVID-19, there are many cases with atypical presentation, including gastrointestinal symptoms. Objective: To describe a COVID-19 case without respiratory symptoms and the role of radiology in detecting COVID-19. Case Description: A 55-year-old male patient came to the hospital complaining of nausea and loss of appetite. Based on the results of the physical examination, there was flatulence. Initial investigations revealed a non-reactive SARS CoV 2 IgG and IgM result. Further non-contrast MSCT Thorax showed infiltrates with bilateral sub-pleural posterolateral consolidation, particularly the left, showing typical pneumonia. Multiple blebs were also found, denoting bronchiectasis. Confirmatory RT-PCR result was positive for SARS CoV 2. Conclusion: COVID-19 usually presents with common respiratory symptoms. However, some patients also experience gastrointestinal symptoms that initially were not detected as COVID-19. In time of COVID-19 pandemic, persistent gastrointestinal symptoms in a high-risk patients warrant further chest imaging and RT-PCR of SARS CoV-2 to detect or exclude the possibility of COVID-19 diagnosis.

Sign in / Sign up

Export Citation Format

Share Document