Related Experiment Video
Updated: Dec 18, 2025
Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
Appendectomy in patient with suspected COVID-19 with negative COVID-19 results: A case report
Changho Kim1, Jong Kun Kim1, In Hwan Yeo1
1Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
Insights
Emergency surgery for patients with suspected COVID-19 should proceed without delay, treating them as confirmed cases. This approach ensures timely surgical intervention while implementing necessary precautions for healthcare workers and patients during the pandemic.
Area of Science:
- Emergency medicine
- Infectious disease management
- Surgical procedures during pandemics
Background:
- The COVID-19 pandemic presents significant challenges for emergency surgery.
- Managing patients with suspected COVID-19 requiring urgent surgical intervention necessitates specialized protocols.
- Established a surveillance system and management principles for emergency room patients with suspected COVID-19.
Observation:
- A 67-year-old male with appendicitis had contact with a COVID-19-positive wife.
- Initial COVID-19 tests were negative, but imaging showed lung abnormalities suggestive of viral pneumonia.
- Emergency surgery was performed using protocols for confirmed COVID-19 cases to avoid delays.
Findings:
- Despite initial negative upper respiratory tests, the patient later tested positive for COVID-19 from a lower respiratory tract specimen post-surgery.
- The case highlights the potential for false negatives in initial COVID-19 screening for surgical patients.
- Implementing confirmed COVID-19 surgical protocols for suspected cases is crucial.
Implications:
- Emergency surgery for suspected COVID-19 should not be delayed; treat as confirmed.
- Protective measures during surgery are vital for healthcare worker safety.
- Timely surgical intervention is paramount, even with diagnostic uncertainty during a pandemic.
Background:
Even at present, we are in the middle of the novel coronavirus disease 2019 (COVID-19) pandemic and are facing challenges in trial and error. Presently, emergency surgery for patients with suspected COVID-19 is burdensome not only for patients but also for healthcare workers. Therefore, we established a surveillance system in the emergency room and established principles for managing patients suspected of COVID-19 who require emergency surgery.
Case Summary:
A 67-year-old man was diagnosed with appendicitis in March 2020. His wife was diagnosed with COVID-19 10 d earlier, and the patient was in close contact with her. The patient tested negative twice on an upper respiratory COVID-19 reverse transcription-polymerase chain reaction screening test, but chest X-ray and chest computed tomography revealed patchy ground-glass opacity in both upper lobes of the patient's lungs. The same emergency surgery procedure for patients with confirmed COVID-19 was applied to this patient suspected of having the disease to ensure that surgery was not delayed while waiting for the reverse transcription-polymerase chain reaction results. A few hours after surgery, the upper respiratory tract specimen taken in the emergency room was negative for COVID-19 but the lower respiratory tract specimen was found to be positive for the disease.
Conclusion:
When COVID-19 is suspected, emergency surgery should be performed as for confirmed COVID-19 without delay.
