Gastric Perforation as a Complication of COVID-19 Infection: A Case Report

Abstract

Pulmonary symptoms are the primary manifestation of the COVID-19 disease, which originated in Wuhan in China in December 2019. However, it is now established to show widespread extrapulmonary manifestations, including gastrointestinal involvement. Abdominal pain, diarrhea, nausea, and vomiting are considered the most common gastrointestinal symptoms. Gastric perforation in association with COVID-19 is rarely reported in the literature. Here, we report a case of a 71-year-old male COVID-19-infected patient, medically free, who presented to the emergency department complaining of severe abdominal pain for a one-week duration. He was diagnosed with a case of perforated viscus and septic shock. The patient was shifted to the operating room for exploratory laparotomy. We aim in this report to highlight this fatal complication of COVID-19 infection in order to improve patients' outcomes.

Keywords: covid 19; gastrointestinal perforation; medical icu; multi-organ dysfunction; sars-cov 2 infection.

Figure 1. Chest X-ray showing pneumoperitoneum suggesting viscus perforation

Figure 2. A CT scan of the abdomen and pelvis

A CT scan of the abdomen and pelvis with oral contrast showing fluid accumulation in the left upper abdomen, related to the stomach and extending inferiorly. It measured about 5.7 x 8.2 x 9.8 cm in size. A fluid collection of 6.9 x 7.3 x 1.7 cm was also found superior to the left hepatic lobe. There was no CT evidence of intra-abdominal free air or contrast leak.

Figure 3. A CT scan of the abdomen and pelvis

A CT scan of the abdomen and pelvis with oral contrast showing fluid accumulation in the left upper abdomen, related to the stomach and extending inferiorly. It measured about 5.7 x 8.2 x 9.8 cm in size. A fluid collection of 6.9 x 7.3 x 1.7 cm was also found superior to the left hepatic lobe. There was no CT evidence of intra-abdominal free air or contrast leak.