Intestinal Perforation Caused by Covid-19

Nahas, Sérgio Carlos; Júnior, José Soares; Sobrado, Lucas Faraco; Sorbello, Mauricio; Segatelli, Vanderlei; Abdala, Edson; Ribeiro-Júnior, Ulysses; Cecconello, Ivan

doi:10.1590/0102-672020190001e1515

Cited by 12 publications

(16 citation statements)

References 10 publications

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“…However, in the present case, these causes were unlikely based on the radiological and surgical findings. The histopathological findings of the present case were similar to those of previously reported cases of COVID-19-induced intestinal ischemia or perforation: partial or total necrosis of the intestinal mucosa and vascular change, such as congestion and organized thrombi [ 5 – 7 ]. These ischemic changes differed from the findings observed in the intestinal ischemia caused by critically ill conditions, such as nonocclusive mesenteric ischemia.…”

Section: Discussionsupporting

confidence: 88%

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Colon perforation as a complication of COVID-19: a case report

et al. 2021

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Background Coagulopathy induced by COVID-19 has received much attention. Arterial and venous thrombosis of multiple organs due to COVID-19-related coagulopathy is associated with a poor outcome. Case presentation A 67-year-female was transferred to our hospital in need of intensive care for severe COVID-19 pneumonia. On day 7 after admission, despite the treatments, her respiratory and hemodynamic status deteriorated. Computed tomography revealed massive ascites and free air as well as wall defects of the transverse colon. An emergency laparotomy was undertaken in the intensive-care unit, and 17 cm of the transverse colon was resected. Histopathological findings revealed two perforation sites of 25 and 7 mm in diameter, necrosis of the intestinal mucosa around the perforation sites, and the microcirculatory thrombosis in the mesentery vessels which was suspected of having been induced by COVID-19-related coagulopathy. Conclusions The case highlights the risk of intestinal ischemia and perforation induced by COVID-19 coagulopathy. Physicians treating COVID-19 should recognize the risk and evaluate patients carefully.

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Section: Discussionsupporting

confidence: 88%

“…We reported a rare case of colon perforation as a complication of COVID-19 pneumonia. Previously reported cases of intestinal ischemia or perforation induced by COVID-19 coagulopathy have been scarce [ 5 – 7 ]. The exact prevalence of ischemia or perforation induced by COVID-19 coagulopathy is unclear.…”

Section: Discussionmentioning

confidence: 99%

Colon perforation as a complication of COVID-19: a case report

et al. 2021

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“…The mortality rate of COVID-19 in the postoperative period was considered high, and three of five patients (60%) who developed symptomatic infection died after prolonged hospital stay in the intensive care unit. Nahas et al have previously published the complicated postoperative course of a few patients who underwent urgent surgery and developed postoperative SARS-CoV-2 infection ( 15 , 16 ). Studies on COVID-19 mortality in the postoperative period are limited, but the general mortality of this infection in patients with cancer is up to 20% ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Sobrado¹,

Nahas²,

Marques³

et al. 2021

Clinics

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Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic. METHODS: This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded. RESULTS: A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (po0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versus 10.3 days, respectively, po0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%). CONCLUSION: Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high.

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“…In turn, some authors reported a case of a patient undergoing a urgent surgery treatment by colorectal cancer without any suspitious of initial contamination by the virus, however, in one's operatory evolution it was confirmed the infection, which led to an disfavor outcome with involvement of the digestive tract, with abdominal focus of sepsis and disfunction in multiple organs, even with intense support and multidisciplinary treatment (26) .…”

Section: The Consequence Of the Delay Of Surgery Procedures Due To Pandemic Covid-19mentioning

confidence: 99%

“…In one's macroscopic analysis it was noticed fibrous material in the colon serous while in the microscopic's one it was observed changes in the ischemic standard, partial or total necrosis of the intestinal wall and lost areas of the mucosa, edema, inflammation and hemorrhage. In subserous areas, adipose tissue necrosis was observed with congestion and several vascular thrombi in hemorrhage organization (26).…”

Section: The Consequence Of the Delay Of Surgery Procedures Due To Pandemic Covid-19mentioning

confidence: 99%

Manifestações Gastrointestinais Diretas E Indiretas

Rebelo¹,

Pinho²,

Oliveira³

et al. 2021

Ciências Médicas: Estudos Clínicos E Revisões Bibliográficas

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A constante evolução da pesquisa na área da saúde está refletida nos avanços das ciências médicas, em que o diagnóstico, o conhecimento sobre antigas e novas doenças e até mesmo a nossa própria atuação e vivências como profissionais estão em permanente status de atualização.O presente livro contém 23 capítulos elaborados por autores pesquisadores da área das ciências médicas e áreas afins. Estando as nossas vidas tão marcadas pela pandemia (ainda em curso) da covid-19 e sendo este livro uma obra que trata sobre saúde, vida e doença, o tema covid-19 corresponde, oportunamente, ao maior número de capítulos.Acredito que esta obra multidisciplinar representa uma importante contribuição para as ciências médicas, especialmente como fonte de revisão e atualização para nós, acadêmicos e profissionais da área.Em nossos livros selecionamos um dos capítulos para premiação como forma de incentivo para os autores, e entre os excelentes trabalhos selecionados para compor este livro, o premiado foi o capítulo 17, intitulado "MÉTODOS LABORATORIAIS UTILIZADOS PARA O DIAGNÓS-TICO DAS LEUCEMIAS: UMA REVISÃO BIBLIOGRÁFICA".

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Intestinal Perforation Caused by Covid-19

Cited by 12 publications

References 10 publications

Colon perforation as a complication of COVID-19: a case report

Colon perforation as a complication of COVID-19: a case report

Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients

Manifestações Gastrointestinais Diretas E Indiretas

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