1. ACUTE ABDOMEN IN AN ELDERLY PATIENT WITH SUSPICION OF SARS-COV-2 INFECTION - DIAGNOSTIC AND TREATMENT CHALLENGES DURING THE PANDEMIC OF 2020 FOR EMERGENCY SURGEON.
- Author
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Toma, Elena-Adelina, Enciu, Octavian, and Miron, Adrian
- Subjects
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SARS-CoV-2 , *OLDER patients , *MECKEL diverticulum , *COVID-19 , *COVID-19 pandemic , *SURGICAL emergencies , *ACUTE abdomen - Abstract
After the emergence of the SARS-CoV-2 pandemic in early 2020, surgery has seen shifts in diagnostic and management paradigms, with a new focus on maintaining a safe environment for both patient and surgeon, all the while ensuring the proper medical care. Despite rRT-PCR testing being the preferred method of diagnosing the infection, multiple studies have shown that chest CT has exhibited superior specificity. We present the case of an 84-year old patient who presented with fever, abdominal pain and multiple chronic ailments, as well as recent hospitalization in another unit that had multiple COVID-19 patients diagnosed shortly after her discharge. She tested negative for SARS-CoV-2 but had suggestive radiological signs, hence she was treated as a suspect. Forty-eight hours after admission her state worsened and emergency surgery was performed, which revealed gangrenous Meckel's diverticulum. The postoperative course was uneventful and the patient was discharged on postoperative day 5, but she tested positive for SARS-CoV-2 six days after discharge (screening testing). She remained in good health 30 days postoperatively and did not need intensive care measures for COVID-19. This underlines two issues brought forth by the pandemic in 2020: that chest CT should always be performed preoperatively, even in patients whose rRT-PCR tests are negative, and that geriatric patients can easily be misdiagnosed due to abnormal clinical manifestations and this can be overlooked while doctors are busy looking for COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2020