Amaral Lucas Tadashi Wada, Brito Vanessa Mizubuti, Beraldo Gabriel Laverdi, Fonseca Eduardo Kaiser Ururahy Nunes, Yokoo Patrícia, Talans Aley, Oranges Filho Marcelo, Chate Rodrigo Caruso, Baroni Ronaldo Hueb, Szarf Gilberto
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2020 Oct 16;18:eRC5831. doi: 10.31744/einstein_journal/2020RC5831. eCollection 2020.
The COVID-19 became a pandemic in early 2020. It was found, at first, that the main manifestations of this new virus occur through respiratory and constitutional symptoms. Therefore, chest tomography was elected as the best imaging test to assess the extent of pulmonary involvement and as a good prognostic predictor for the disease. However, as new studies were produced, the gastrointestinal involvement of COVID-19 becomes more evident, with reports from patients who manifested mainly or only gastrointestinal symptoms in the course of the disease. Thus, in some cases, the initial investigation is carried out at the emergency department with an abdominal computed tomography. We report a case series of ten patients who came to the emergency department of our institution with a chief gastrointestinal complaint, and were initially submitted to an abdominal computed tomography as the first investigation. Although most of the patients did not have significant changes in the abdominal images, most reported patients had pulmonary findings visualized at the lung bases, which were later designated as typical COVID-19 pulmonary findings on chest computed tomography. Only one patient had atypical COVID-19 lung changes on chest computed tomography. All patients had a positive real-time polymerase chain reaction for COVID-19. It is imperative to alert radiologists, especially abdominal radiologists, with the possibility of COVID-19 isolated gastrointestinal symptoms. Besides, it must become a habit to radiologists to assess the pulmonary basis on abdominal scans, a site commonly affected by the new coronavirus.
2020年初，新型冠状病毒肺炎成为大流行病。起初发现，这种新型病毒的主要表现通过呼吸道和全身症状出现。因此，胸部断层扫描被选为评估肺部受累程度的最佳影像学检查，也是该疾病良好的预后预测指标。然而，随着新研究的开展，新型冠状病毒肺炎的胃肠道受累情况变得更加明显，有报告称患者在病程中主要或仅表现出胃肠道症状。因此，在某些情况下，最初的检查是在急诊科进行腹部计算机断层扫描。我们报告了一组10例病例，这些患者因主要胃肠道症状前来我院急诊科，最初接受腹部计算机断层扫描作为首次检查。尽管大多数患者腹部影像无明显变化，但大多数报告患者在肺底部有肺部表现，这些表现后来在胸部计算机断层扫描中被确定为典型的新型冠状病毒肺炎肺部表现。只有1例患者在胸部计算机断层扫描中有非典型的新型冠状病毒肺炎肺部改变。所有患者新型冠状病毒实时聚合酶链反应均呈阳性。必须提醒放射科医生，尤其是腹部放射科医生，注意新型冠状病毒肺炎出现孤立胃肠道症状的可能性。此外，放射科医生必须养成在腹部扫描时评估肺部情况的习惯，肺部是新型冠状病毒常见的受累部位。
