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急性外科样腹痛作为 COVID-19 感染的胃肠道表现:哥伦比亚的一例病例报告。

Acute surgical-like abdomen as a gastrointestinal manifestation of COVID-19 infection: a case report in Colombia.

机构信息

Clinical Studies and Clinical Epidemiology Division, Digestive Endoscopy Division, Fundación Santa Fe de Bogotá, Bogotá, Colombia.

Fundación Santa Fe de Bogotá, Calle 119a# 7-49, Bogotá, Colombia.

出版信息

BMC Gastroenterol. 2021 Apr 22;21(1):187. doi: 10.1186/s12876-021-01762-0.

Abstract

BACKGROUND

The SARS-CoV-2 pandemic is a considerable public health problem, which has caused a burden on health systems in many countries. Despite the existence of multiple studies on the different digestive symptoms and their relationship with this disease, it is still vital to highlight the severity of the different symptoms, the need to diagnose it properly and quickly. Currently in Colombia there are no writings that highlight the above.

CASE PRESENTATION

This article reports the case of a 37-year-old female patient, with no important history, who consulted for 10 h of a generalized intense abdominal pain, of sudden onset, associated with multiple stools of diarrheal consistency, and no respiratory symptoms and no epidemiological exposure. Physical examination with intense pain in the colic frame with tenderness. It was decided to rule out surgical pathology and a CT scan was performed finding no evidence of acute intra-abdominal pathology, but with a peripheral alveolar, and ground-glass opacities at lung bases, classic COVID-19 radiological pattern, confirmed by a positive RT-PCR for SARS-CoV-2, leading to consider that the gastrointestinal symptoms were secondary to this infection. Symptomatic management was given with subsequent improvement.

CONCLUSIONS

It is extremely important to present this first case report of a young female COVID-19 patient with an acute abdominal pain as the main clinical manifestation, that almost culminates in a surgical procedure; demonstrating the scope of gastrointestinal symptoms secondary to SARS-CoV-2 infection.

摘要

背景

SARS-CoV-2 大流行是一个相当严重的公共卫生问题,它给许多国家的卫生系统带来了负担。尽管有许多关于不同消化系统症状及其与该疾病关系的研究,但仍有必要强调不同症状的严重程度,需要快速正确地诊断。目前在哥伦比亚,没有强调上述情况的文献。

病例介绍

本文报告了一例 37 岁女性患者的病例,无重要病史,她因全身剧烈腹痛就诊 10 小时,腹痛突然发作,伴有多次腹泻便,无呼吸道症状,无流行病学接触史。体格检查发现结肠框有强烈疼痛,伴有压痛。决定排除外科病理学,并进行 CT 扫描,未发现急性腹腔内病理学证据,但肺部基底有周边肺泡和磨砂玻璃样混浊,具有典型的 COVID-19 放射学模式,通过 SARS-CoV-2 的 RT-PCR 检测呈阳性,从而认为胃肠道症状是由该感染引起的。给予对症治疗,随后症状有所改善。

结论

报告首例年轻女性 COVID-19 患者以急性腹痛为主要临床表现的病例非常重要,几乎导致手术;证明了 SARS-CoV-2 感染继发的胃肠道症状的范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d71/8063435/25fec4e3868e/12876_2021_1762_Fig1_HTML.jpg

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