scholarly journals COVID-19 gastrointestinal manifestation presenting as acute surgical like abdomen

2021 ◽  
Vol 8 (9) ◽  
pp. 2848
Author(s):  
Krishna Ramavath ◽  
Siddharth S. Rao ◽  
Nyna Sindhu ◽  
Tushar Parmeshwar ◽  
Pranay Palle
Keyword(s):  
Respiratory Symptoms ◽  
Rna Virus ◽  
Gastrointestinal Symptoms ◽  
Sudden Onset ◽  
Virus Protein ◽  
Loose Stool ◽  
Diagnostic Dilemma ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Gastrointestinal Manifestation

COVID-19 disease is caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) which can cause respiratory symptoms more. It can cause gastrointestinal symptoms also due to this RNA virus protein binding to the angiotensin converting enzyme 2 (ACE2) receptors which are abundantly present in stomach, small intestine, large intestine and liver. The gastrointestinal manifestations of COVID-19 disease can present as acute surgical abdomen which can create diagnostic dilemma. We presented a case of COVID-19 disease, admitted in our hospital. Later he had symptoms of acute surgical abdomen symptoms like sudden onset abdominal pain, nausea, vomiting and loose stool without blood. He was properly evaluated and conservatively managed. The gastrointestinal manifestations of COVID-19 disease can present as acute surgical abdomen. So, these patients properly evaluated and then only surgical plan will be made according pathology.

scholarly journals Ogilvie syndrome in a COVID-19 patient with pneumonia, absolute tachyarrhythmia and heart failure: A case report

2021 ◽  
Vol 52 (2) ◽  
pp. 160-164
Author(s):  
Zoran Matković ◽  
Nataša Đekić-Matković
Keyword(s):  
Heart Failure ◽  
Respiratory Symptoms ◽  
Fatal Outcome ◽  
Gastrointestinal Symptoms ◽  
Mucosal Immune Response ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Therapeutic Measures ◽  
Ogilvie Syndrome

The COVID-19 pandemic has recently spread worldwide presenting primarily in form of pneumonia. Gastrointestinal manifestations such as nausea, vomiting, diarrhoea and abdominal pain are less common than respiratory symptoms. However, critically ill patients may develop digestive complications including acute pseudo-obstruction of colon-Ogilvie syndrome. Gastrointestinal symptoms can manifest before the onset of typical respiratory symptoms. Common mucosal immune response underly both-pulmonary and gastrointestinal manifestations (high expression of angiotensin-converting enzyme 2 receptors). This article described a 75-year old female patient who arise Ogilvie syndrome during viral bilateral pneumonia induced by COVID-19. Patient also had an absolute tachyarrhythmia and hearth failure. Diameter of caecum, ascending and transverse colon was 12 to 14 cm. The walls of this segment of large bowel were deserosed, with threatening perforation. Right colectomy was performed. Nine days after the surgery, despite all therapeutic measures taken, there was a fatal outcome due to pulmonary thromboembolisation.

scholarly journals P56 Gastrointestinal manifestations of COVID-19: a retrospective analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Osamah Niaz ◽  
Aaliya Uddin ◽  
Sangeetha Thomas ◽  
Katherine Harries ◽  
Sarah-Jane Walton ◽  
...  
Keyword(s):  
Ct Scan ◽  
Retrospective Analysis ◽  
Gastrointestinal Symptoms ◽  
District General Hospital ◽  
Chest Ct ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Abdominal Ct Scan

Abstract Introduction Emerging data suggests that SARS-CoV-2 acts via the angiotensin-converting-enzyme-2 (ACE2) receptors in the cells, also present in the gastrointestinal and liver cells, resulting in gastrointestinal manifestations of COVID-19. It is challenging to diagnose COVID-19 in patients presenting with only gastrointestinal symptoms, with early suspicion and visualisation of the lung bases on computerised tomography(CT) abdomen scans being helpful. Methods Single-centre retrospective analysis of abdominal/chest CT scans was conducted within a District General Hospital. From the 6000 CT scans between March and April 2020, 1557(26%) were abdominal, 230 of which had chest CT scans with COVID-19 positive changes. 49 patients with CT abdomen and a positive CT Chest were shortlisted. All recorded documentation was assessed using online clinical portal and tabulated using Microsoft Excel®. Subdivision into 3 groups was: 1) primary gastrointestinal symptom, normal CT abdomen, 2) common COVID-19 symptoms with gastrointestinal symptoms, normal CT abdomen 3) gastrointestinal symptoms, abdominal pathology on radiology. Results COVID-19 related changes were seen on CT scans with no abdominal pathology noted in 33% (n = 16) patients with primary gastrointestinal symptoms. Further 18% (9 patients) presented with gastrointestinal symptoms alongside other common COVID-19 symptoms, however abdominal CT scan was normal. CT abdomen of these 25 patients were studied by a consultant radiologist, who examined the lung bases on the abdominal CT scan for COVID-19 related changes, which was seen in 92% patients. In 8% of the cases where the lung bases on the CT abdomen were normal, COVID-19 related changes were apparent on the CT chest. Conclusions CT scans of the abdomen should be supplemented with CT scans of the chest, when appropriate, for early accurate diagnosis, early treatment and triage to the correct wards, especially at the height of the pandemic.

scholarly journals Clinical Course of a Covid-19 Patient with Gastrointestinal Symptoms- A Case Report

2020 ◽  
Vol 8 (2) ◽  
pp. 148-151
Author(s):  
Sidra Agarwal ◽  
Hemanshi Mistry
Keyword(s):  
New York ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Respiratory Symptoms ◽  
Clinical Course ◽  
Gastrointestinal Symptoms ◽  
Oral Route ◽  
Nasopharyngeal Swab ◽  
Virus Shedding ◽  
Angiotensin Converting Enzyme 2

Background: COVID-19 most commonly presents with respiratory symptoms. However, it can involve the gastrointestinal tract causing symptoms like diarrhea and the resultant shedding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces. This is due to the virus adhering to angiotensin-converting enzyme 2 receptors largely present in the gastrointestinal tract. This case report recommends routine stool Real-Time Reverse Polymerase Chain Reaction (rRT-PCR) testing for patients presenting with gastrointestinal symptoms. The Case: A healthy 36-year-old male healthcare worker in New York who tested positive for SARS-CoV-2 infection through rRT-PCR of the nasopharyngeal swab. After 7 days of convalescence, he recovered from influenza like symptoms after which he predominantly developed diarrhea, nausea, vomiting and extreme fatigue. Cough was the only lower respiratory symptom during the 3rd week of the clinical course. Anosmia or ageusia preceding the onset of respiratory symptoms was also reported. Due to the outbreak of the pandemic and New York being the epicenter at the time, the patient was recommended to self-isolate with supportive management through antipyretics and electrolyte replacement. Conclusion: This case highlights a SARS-CoV-2 PCR positive patient with predominant gastrointestinal symptoms. The reports regarding virus shedding in feces suggest that SARS-CoV-2 could be transmitted via fecal-oral route and thus routine stool rRT-PCR testing can aid in transmission-based precautions. Furthermore, reports of viral ribonucleic acid present in the stool, suggests direct infectivity of the virus on the intestinal tract. Therefore, screening in patients with only gastrointestinal symptoms can potentially help to contain the virus spread.

scholarly journals Gastrointestinal Aspects of COVID-19: A Review

2020 ◽  
Vol 8 (T1) ◽  
pp. 52-54
Author(s):  
Gontar Alamsyah Siregar ◽  
Ginanda Putra Siregar ◽  
Darmadi Darmadi
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Respiratory Symptoms ◽  
Protective Equipment ◽  
Converting Enzyme ◽  
Fecal Examination ◽  
Angiotensin Converting Enzyme 2 ◽  
Oral Transmission ◽  
Gastrointestinal Manifestation ◽  
Disease Spreading

Coronaviruses commonly cause mild infections, but recently severe acute respiratory syndrome-coronavirus (SARS-CoV)-2 caused a pandemic of coronavirus disease 2019 (COVID-19). A total of 3,181,642 cases were confirmed globally. Gastrointestinal tract may be involved in COVID-19 due to the presence of angiotensin converting enzyme-2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) in small intestine and colon which are mandatory for SARS-CoV-2 invasion. A proportion of patients with COVID-19 had gastrointestinal manifestation without respiratory symptoms. Viable virus can also be isolated from feces of patients. Fecal-oral transmission should be considered in controlling disease spreading. Fecal examination may also be considered to diagnose COVID-19, especially in areas with limited personal protective equipment.

scholarly journals Acute surgical‐like abdomen as a gastrointestinal manifestation of COVID-19 infection: a case report in Colombia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fernando Sierra-Arango ◽  
Cathalina Vergara-Cabra ◽  
Mariana Vásquez-Roldan ◽  
Erika D. Pérez-Riveros
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Gastrointestinal Symptoms ◽  
Public Health Problem ◽  
Young Female ◽  
Sudden Onset ◽  
First Case ◽  
Symptomatic Management ◽  
Radiological Pattern ◽  
Gastrointestinal Manifestation

Abstract Background The SARS-CoV-2 pandemic is a considerable public health problem, which has caused a burden on health systems in many countries. Despite the existence of multiple studies on the different digestive symptoms and their relationship with this disease, it is still vital to highlight the severity of the different symptoms, the need to diagnose it properly and quickly. Currently in Colombia there are no writings that highlight the above. Case presentation This article reports the case of a 37-year-old female patient, with no important history, who consulted for 10 h of a generalized intense abdominal pain, of sudden onset, associated with multiple stools of diarrheal consistency, and no respiratory symptoms and no epidemiological exposure. Physical examination with intense pain in the colic frame with tenderness. It was decided to rule out surgical pathology and a CT scan was performed finding no evidence of acute intra-abdominal pathology, but with a peripheral alveolar, and ground-glass opacities at lung bases, classic COVID-19 radiological pattern, confirmed by a positive RT-PCR for SARS-CoV-2, leading to consider that the gastrointestinal symptoms were secondary to this infection. Symptomatic management was given with subsequent improvement. Conclusions It is extremely important to present this first case report of a young female COVID-19 patient with an acute abdominal pain as the main clinical manifestation, that almost culminates in a surgical procedure; demonstrating the scope of gastrointestinal symptoms secondary to SARS-CoV-2 infection.

scholarly journals GASTROINTESTINAL MANIFESTATIONS OF COVID 19: A BRIEF REVIEW

2020 ◽  
pp. 195-197
Author(s):  
Nikhat Naaz
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Viral Pneumonia ◽  
Google Scholar ◽  
Gastrointestinal Manifestations ◽  
Common Presentation ◽  
Pubmed Database ◽  
Gi Symptoms

Background: In Dec 2019, a series of pneumonia cases were identified in Wuhan, China with presentations similar to viral pneumonia which later spread worldwide and was declared as COVID 19 Pandemic. Most common presentation were fever and respiratory symptoms and less common symptoms include GI symptoms like nausea, vomiting, abdominal pain and diarrhea. Objectives: The objective of this article is to review the gastrointestinal manifestations of COVID 19 patients and to understand its importance while diagnosing patients with COVID 19. Methodology: Pubmed database and Google scholar database were searched between Dec 2019 to June 2020 for studies including COVID 19 confirmed patients with GI symptoms. Findings: Many of these studies observed gastrointestinal symptoms like decreased appetite, diarrhea, nausea, vomiting and abdominal pain to be present in a substantial no of COVID 19 confirmed patients. Conclusions: Failure to recognize COVID 19 patients with predominant digestive symptoms may lead to undue spread of virus for a much longer period and may lead to uncontrollable dissemination of the virus. Recommendation: All COVID 19 confirmed patients should be evaluated for GI symptoms also apart from respiratory symptoms. Patients with predominantly GI symptoms should also be suspected as COVID 19 patients during the current COVID 19 pandemic phase.

scholarly journals Clinical peculiarities of gastrointestinal symptoms in children with food allergy

2020 ◽  
Keyword(s):  
Food Allergy ◽  
Respiratory Symptoms ◽  
Digestive System ◽  
Age Groups ◽  
Gastrointestinal Symptoms ◽  
Main Group ◽  
Food Allergies ◽  
Moderate Intensity ◽  
Provocative Test ◽  
Gastrointestinal Manifestations

Introduction. Pediatric allergy problems are widely spread among children of almost all age groups. Number of cases with combined allergic a digestive disorders increases and study of gastrointestinal lesions in children with allergies became an urgent medical and social problem. It is based on the increasing frequency of both allergy and pathology of the digestive system, increasing severity of cases and necessity to analyze type of gastrointestinal disorder in children with allergy and correlation among it. Objective. To study the clinical features of gastrointestinal symptoms in children with food allergies. Materials and methods. 169 pediatric patients 3–17 years old were examined. The main group was of 105 children with food allergies, the control group – 64 children without allergies. Verification of food allergy and pathology of the digestive system was carried out in accordance with the current protocols. All patients had skin prick tests, provocative test, determination of specific IgE. All patients were divided into 3 groups by age: 1st – 3–6 years old, 2nd – 7–11 years old, 3rd – 12–17 years old. The results were processed by the methods of variation statistics. Results. Gastrointestinal manifestations were observed in children of all age groups (59 %, 65 %, 74 %). Skin manifestations predominated in the 1st and the 3rd group. Respiratory symptoms – in groups 2 and 3. A combination (more often of skin and gastrointestinal) manifestations was found in group 3. Pain syndrome in children of the main group was characterized by moderate intensity (55.2 %), more often not associated with food intake (45.7 %), localized in the umbilical region (58 %), less often in the epigastrium (23.4 %), in 15 % there was no pain. Dyspeptic syndrome was manifested by nausea (36.2 %), decreased appetite (25.7 %) and belching (17.1 %). Dyspeptic syndrome was absent in 34.3 % of patients. The manifestations of asthenovegetative syndrome were noted in 38.1 % of children in the main group. The correlation between the type of allergen and the reason of gastrointestinal symptoms has not been identified. Conclusions. A variety of clinical manifestations of food allergy has been proven in the form of skin, gastrointestinal, respiratory symptoms and their combination. Gastrointestinal symptoms indicate the presence of functional disorders of the digestive tract. With age, the variety of food allergens increases, without qualitatively affecting the nature of gastrointestinal symptoms.

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma

2020 ◽  
Vol 13 (12) ◽  
pp. e237257
Author(s):  
Monidipa Banerjee ◽  
Eiman Haj Ahmed ◽  
Kathryn Foster ◽  
Arundoss Gangadharan
Keyword(s):  
Ipratropium Bromide ◽  
Obstructive Hydrocephalus ◽  
Sudden Onset ◽  
Unique Case ◽  
Diagnostic Dilemma ◽  
Vp Shunt ◽  
Life Threatening ◽  
Unilateral Mydriasis ◽  
The Brain ◽  
Rule Out

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

scholarly journals Development of a large spontaneous pneumothorax after recovery from mild COVID-19 infection

2021 ◽  
Vol 14 (1) ◽  
pp. e238863
Author(s):  
Krishidhar Nunna ◽  
Andrea Barbara Braun
Keyword(s):  
Chest Pain ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Spontaneous Pneumothorax ◽  
Respiratory Symptoms ◽  
Pulmonary Complication ◽  
Sudden Onset ◽  
Medical Professionals ◽  
Chest Imaging ◽  
Igg Antibodies

A previously healthy 37-year-old man presented with fevers and myalgias for a week with a minimal dry cough. Initial SARS-CoV-2 nasopharyngeal testing was negative, but in light of high community prevalence, he was diagnosed with COVID-19, treated with supportive care and self-quarantined at home. Three days after resolution of all symptoms, he developed sudden onset chest pain. Chest imaging revealed a large right-sided pneumothorax and patchy subpleural ground glass opacities. IgM and IgG antibodies for SARS-CoV-2 were positive. His pneumothorax resolved after placement of a small-bore chest tube, which was removed after 2 days.This case demonstrates that patients with COVID-19 can develop a significant pulmonary complication, a large pneumothorax, despite only minimal lower respiratory tract symptoms and after resolution of the original illness. Medical professionals should consider development of a pneumothorax in patients who have recovered from COVID-19 and present with new respiratory symptoms.

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