Pseudo-Appendicitis in an Adolescent With COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) pandemic is a global health emergency in 2020. Patients with COVID-19 may present with variable clinical features, involving pulmonary, gastrointestinal, neurological, and cardiovascular symptoms. Notwithstanding, the acute abdomen as a presentation of COVID-19 is rare. We report an adolescent with confirmed COVID-19, initially presented with acute abdominal pain mimicking appendicitis. Our case highlights the inaccuracy of using clinical diagnosis for surgical abdomen in the COVID-19 era. Clinicians should perform screening COVID-19 tests in patients presenting with acute abdominal pain before admitting the patients to implement proper preventive measures in order to reduce viral transmission to other patients and healthcare professionals. Confirmed COVID-19 patients with acute abdomen may need proper imaging tests before surgery to avoid iatrogenic complications.

Keywords: acute abdomen; appendicitis; covid-19; sars-cov-2; surgical abdomen.

Figure 1. Ultrasound (left) shows non-compressible appendix (black arrow) and CT (right) shows normal appendix (white arrow)

Figure 2. Proposed mechanisms of COVID-19 induced pseudo-appendicitis

SARS-CoV-2, severe acute respiratory syndrome coronavirus 2