Colonic perforation in patients with COVID-19 pneumonia – case reports

2021 ◽  
Vol 100 (7) ◽  
Keyword(s):  
Respiratory Symptoms ◽  
Case Reports ◽  
Colonic Perforation ◽  
Colon Perforation ◽  
Internal Environment ◽  
Right Colon ◽  
Gastrointestinal Complications ◽  
Pneumonia Case ◽  
Symptoms And Signs ◽  
Chronic Diverticulitis

Introduction: Gastrointestinal complications in critically ill patients during the COVID-19 pandemic pose a diagnostic and treatment dilemma. Case report: We present two cases of SARS-CoV-2 positive patients treated in our department for colon perforation. One patient was operated for a diastasic right colon perforation due to acute over distension of the bowel. The perforation in the second case was associated with chronic diverticulitis. Conclusion: These cases highlight the fact that besides typical respiratory symptoms and signs of COVID-19, digestive symptoms also occur. These can caused by intestinal perforation, be it directly or due to changing homeostasis of the internal environment.

scholarly journals Presenting Psychiatric and Neurological Symptoms and Signs of Brain Tumors before Diagnosis: A Systematic Review

2021 ◽  
Vol 11 (3) ◽  
pp. 301
Author(s):  
Fatima Ghandour ◽  
Alessio Squassina ◽  
Racha Karaky ◽  
Mona Diab-Assaf ◽  
Paola Fadda ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neurological Symptoms ◽  
World Health ◽  
Exclusion Criteria ◽  
Comprehensive Description ◽  
Brain Tumor Diagnosis ◽  
Health Organization ◽  
Symptoms And Signs

Brain tumors can present with various psychiatric symptoms, with or without neurological symptoms, an aspect that complicates the clinical picture. However, no systematic description of symptoms that should prompt a neurological investigation has been provided. This review aims to summarize available case reports describing patients with brain tumors showing psychiatric symptoms before brain tumor diagnosis, in order to provide a comprehensive description of these symptoms as well as their potential relationship with delay in the diagnosis. A systematic literature review on case reports of brain tumors and psychiatric symptoms from 1970 to 2020 was conducted on PubMed, Ovid, Psych Info, and MEDLINE. Exclusion criteria comprised tumors not included in the World Health Organization (WHO) Classification 4th edition and cases in which psychiatric symptoms were absent or followed the diagnosis. A total of 165 case reports were analyzed. In a subset of patients with brain tumors, psychiatric symptoms can be the only manifestation or precede focal neurological signs by months or even years. The appearance of focal or generalized neurological symptoms after, rather than along with, psychiatric symptoms was associated with a significant delay in the diagnosis in adults. A timely assessment of psychiatric symptoms might help to improve early diagnosis of brain tumors.

scholarly journals Acute Pancreatitis: An Atypical Presentation

2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Reports ◽  
Case Series ◽  
Normal Serum ◽  
Intravenous Fluids ◽  
Serum Enzyme ◽  
Serum Lipase ◽  
Upper Abdominal ◽  
Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

Rare case of acute abdomen: Right colon perforation due to the colon diverticulitis

2018 ◽  
Vol 15 (3) ◽  
pp. 169
Author(s):  
Faruk Pehlivanli ◽  
Gökhan Karaca ◽  
Oktay Aydin ◽  
Sevilay Vural ◽  
Figen Coskun
Keyword(s):  
Acute Abdomen ◽  
Rare Case ◽  
Colon Perforation ◽  
Right Colon ◽  
Colon Diverticulitis

scholarly journals Cystic Fibrosis with Severe Anaemia and Hypoproteinaemia

2019 ◽  
Vol 38 (2) ◽  
pp. 118-121
Author(s):  
Md Abu Bakkar Siddique ◽  
Kalimuddin Khan ◽  
Aparajita Bera ◽  
Sudipta Ghorai ◽  
Jasmine Mallik ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Symptoms ◽  
Severe Anaemia ◽  
Initial Presentation ◽  
Elastase Level ◽  
Symptoms And Signs

The presentation of cystic fibrosis (CF) is dependent upon which organs are affected. Severe anaemia is reported to occur rarely in patients with CF. We are presenting a case of 2 months old infant admitted with anaemia, malnutrition, hypoproteinaemia and hypoalbuminaemia, without any pulmonary symptoms at the initial presentation. Abnormal sweat chlorides and low faecal elastase level confirmed the diagnosis of CF. Respiratory symptoms and signs developed later on further follow up.

scholarly journals Electrical Impedance Tomography and Prone Position During Ventilation in COVID-19 Pneumonia: Case Reports and a Brief Literature Review

2020 ◽  
Vol 24 (4) ◽  
pp. 287-292
Author(s):  
Serena Tomasino ◽  
Rosa Sassanelli ◽  
Corrado Marescalco ◽  
Francesco Meroi ◽  
Luigi Vetrugno ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Literature Review ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Case Reports ◽  
Prone Positioning ◽  
Impedance Tomography ◽  
Pneumonia Case ◽  
Different Types ◽  
Novel Coronavirus

At the end of 2019, a novel coronavirus (COVID-19) was identified as the cause of a cluster of pneumonia cases, with high needs of mechanical ventilation in critically ill patients. It is still unclear whether different types of COVID-19 pneumonia require different ventilator strategies. With electrical impedance tomography (EIT) we evaluated, in real time and bedside, the distribution of ventilation in the different pulmonary regions before, during, and after pronation in COVID-19 respiratory failure. We present a brief literature review of EIT in non-COVID-19 patients and a report of 2 COVID-19 patients: one that did not respond well and another one that improved during and after pronation. EIT might be a useful tool to decide whether prone positioning should or should not be used in COVID-19 pneumonia.

Respiratory symptoms and signs

Medicine ◽  
2016 ◽  
Vol 44 (4) ◽  
pp. 205-212 ◽  
Author(s):  
Suveer Singh
Keyword(s):  
Respiratory Symptoms ◽  
Symptoms And Signs

scholarly journals Spontaneous muscle hematoma in older patients with COVID-19: two case reports and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sara Rogani ◽  
Valeria Calsolaro ◽  
Riccardo Franchi ◽  
Alessia Maria Calabrese ◽  
Chukwuma Okoye ◽  
...  
Keyword(s):  
Literature Review ◽  
Older Patients ◽  
Respiratory Symptoms ◽  
Distress Syndrome ◽  
Case Reports ◽  
Coagulation System ◽  
Blood Tests ◽  
Hemorrhagic Complications ◽  
History Of ◽  
Caucasian Female

Abstract Background In late December 2019, a cluster of pneumonia cases due to a novel betacoronavirus, SARS-CoV-2 was reported in China. The so-called COVID 19 is responsible not only for respiratory symptoms, from mild up to pneumonia and even acute respiratory distress syndrome, but also for extrapulmonary involvement. Cases presentation Here we present two cases of spontaneous muscle hematoma in patients with SARS-CoV-2 infection, both on therapeutic LMWH for atrial fibrillation: the first one was an 86-year-old Caucasian female with a history of hypertensive cardiomyopathy and the second one was an 81-year-old Caucasian male with a history of hypertension, diabetes and ischemic heart disease. Blood tests revealed a considerable drop of hemoglobin and alterations of coagulation system. In both cases, embolization of femoral artery was performed. A few other cases of bleeding manifestations are reported in literature, while a lot has been published about the hypercoagulability related to COVID-19. Conclusions Our reports and literature review highlight the need of active surveillance for possible hemorrhagic complications in patients with SARS-CoV-2 infection.

scholarly journals GASTROINTESTINAL COMPLICATIONS OF CORONAVIRUS DISEASE (COVID-19)

2021 ◽  
Vol 34 (3) ◽  
Author(s):  
Marcelo Augusto Fontenelle RIBEIRO-JUNIOR ◽  
Samara de Souza AUGUSTO ◽  
Yasmin Garcia Batista ELIAS ◽  
Cássia Tiemi Kawase COSTA ◽  
Paola Rezende NÉDER
Keyword(s):  
Early Diagnosis ◽  
Case Reports ◽  
Case Series ◽  
Pneumatosis Intestinalis ◽  
Alveolar Epithelial Cells ◽  
High Expression ◽  
Target Cells ◽  
Gastrointestinal Complication ◽  
Gastrointestinal Complications ◽  
Expression Levels

ABSTRACT Background: It is currently understood that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) directly enters target cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. Accordingly, tissues with high expression levels of ACE2 are more susceptible to infection, including pulmonary alveolar epithelial cells, small intestine enterocytes, cholangiocytes, and vascular endothelial cells. Considering the atypical manifestations of COVID-19 and the challenges of early diagnosis, this review addresses the possible gastrointestinal complications of the disease. Method: The phrase “Gastrointestinal complication of COVID” was searched in the PubMed, Medline, and SciELO databases. Due to the heterogeneity of the studies included in the present review, a narrative synthesis of the available qualitative data was performed. Result: The literature search retrieved 28 articles, primarily case reports and case series, for the qualitative analysis of gastrointestinal complications of COVID-19, in addition to two retrospective cohort and one case-control. The studies focused on hemorrhagic, thrombotic, ischemic, and perforation complications, in addition to acute pancreatitis and pneumatosis intestinalis. Conclusion: There is a straight relationship between high expression levels of ACE2 in the gastrointestinal tract and its greater susceptibility to direct infection by SARS-CoV-2. So, it is important to consider the gastrointestinal infection manifestations for early diagnosis and treatment trying to avoid more serious complications and death.

scholarly journals Extrapulmonary manifestations and complications of severe acute respiratory syndrome coronavirus 2 infection: a systematic review

2021 ◽  
Author(s):  
J Cho ◽  
J Lee ◽  
CH Sia ◽  
CS Koo ◽  
BYQ Tan ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Respiratory Symptoms ◽  
Case Reports ◽  
Meta Analysis ◽  
Severe Disease ◽  
Late Phase ◽  
Cardiac Injury ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Venous Thromboembolic Events

Introduction: We aimed to describe the extrapulmonary manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, including their frequency, onset with respect to respiratory symptoms, pathogenesis and association with disease severity. Methods: We searched the MEDLINE and Embase databases for SARS-CoV-2-related studies. Meta-analysis, observational studies, case series and case reports published in English or Chinese between 1 January and 1 May 2020 were included. Reports with only paediatric or obstetric cases were excluded. Results: 169 articles were included. Early manifestations (preceding respiratory symptoms until Day 6 of onset) included olfactory and gustatory disturbance (self-reported in up to 68% and 85% of cases, respectively), gastrointestinal symptoms (up to 65.9%) and rash (up to 20.4%). From Day 7 onwards, hypercytokinaemia, paralleled multi-organ complications including acute cardiac injury (pooled incidence of 17.7% in 1,412 patients, mostly with severe disease and 17.4% mortality), kidney and liver injury (up to 17% and 33%, respectively) and thrombocytopenia (up to 30%). Hypercoagulability resulted in venous thromboembolic events in up to 31% of all patients. Uncommon disease presentation and complications comprised Guillain-Barré syndrome, rhabdomyolysis, otitis media, meningoencephalitis and spontaneous pneumomediastinum. Conclusion: Although the systemic manifestations of SARS-CoV-2 infection are variegated, they are deeply interwoven by shared mechanisms. Two phases of extrapulmonary disease were identified: (a) an early phase with possible gastrointestinal, ocular and cutaneous involvement and (b) a late phase characterised by multiorgan dysfunction and clinical deterioration. A clear, multidisciplinary consensus to define and approach thromboinflammation and cytokine release syndrome in SARS-CoV-2 is needed.

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