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Gastrointestinal perforation in a critically ill patient with COVID-19 pneumonia
Aaron Kangas-Dick1, Christopher Prien1, Kristin Rojas1
1Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Abstract:
Gastrointestinal complications in critically ill patients during the COVID-19 pandemic pose a diagnostic and treatment dilemma. We present a case of a 74-year-old male who was brought to our emergency department with worsening shortness of breath, fever, and dry cough and was found to have COVID-19 pneumonia. Early in his hospital course, he was admitted to the intensive care unit, and was found to have significant abdominal distension with large amounts of simple fluid on bedside ultrasound. Bedside paracentesis returned succus and enteric feeds, and a methylene blue test confirmed a likely gastrointestinal perforation. The patients' family refused surgical intervention and the patient underwent bedside drainage. This case represents several critical dilemmas clinicians faced during the recent surge of the COVID-19 pandemic.
Insights
Critically ill patients with COVID-19 pneumonia may develop gastrointestinal complications, such as perforation. This case highlights diagnostic and management challenges during the pandemic.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Infectious Diseases
Background:
- The COVID-19 pandemic presented unique challenges in managing critically ill patients.
- Gastrointestinal complications in these patients created diagnostic and treatment dilemmas.
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