Almafreji Ibrahim, Ranganath Sathyaprakash
Trauma and Orthopaedics, University Hospital Crosshouse, Kilmarnock, GBR.
Emergency Department, University Hospital Ayr, Ayr, GBR.
Cureus. 2020 Sep 14;12(9):e10442. doi: 10.7759/cureus.10442.
An 83-year-old man presented to the emergency department (ED) during the peak of the first wave of the SARS CoV-2 (COVID-19) pandemic with severe abdominal pain, mimicking a severe abdominal pathology. He was found to have features suggestive of COVID-19 infection radiologically, with no leaking aortic aneurysm, bowel ischemia, pancreatitis, or perforation. With worsening symptoms, a repeat computer tomography (CT) scan four days later showed features of bowel ischemia, and he underwent a laparotomy and right hemicolectomy. Four real-time reverse transcription-polymerase chain reaction (rRT-PCR) tests were negative. He was still considered to be infected with COVID-19 and died from complications arising from multi-organ failure. This case highlights an atypical presentation of a possible COVID-19 infection, the urgency to have additional diagnostic tests apart from rRT-PCR, and the necessity to use the appropriate personal protective equipment (PPE) during the pandemic.
一名83岁男性在严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒）大流行第一波高峰期前往急诊科，主诉严重腹痛，疑似患有严重腹部疾病。经影像学检查发现其具有新冠病毒感染的特征，但未发现主动脉瘤破裂、肠缺血、胰腺炎或穿孔。随着症状加重，四天后复查计算机断层扫描（CT）显示有肠缺血特征，遂行剖腹探查术及右半结肠切除术。四次实时逆转录聚合酶链反应（rRT-PCR）检测均为阴性。他仍被认为感染了新冠病毒，并死于多器官功能衰竭引发的并发症。该病例凸显了新冠病毒感染可能出现的非典型表现、除rRT-PCR之外进行其他诊断检测的紧迫性以及在大流行期间使用适当个人防护装备（PPE）的必要性。
