John Jeffrey, Anto Dileep, Musthafa Shameel, Moustafa Omar, Zarour Ahmad
Acute Care Surgery, Hamad Medical Corporation, Doha, QAT.
Surgery, Hamad Medical Corporation, Doha, QAT.
Cureus. 2024 Oct 4;16(10):e70839. doi: 10.7759/cureus.70839. eCollection 2024 Oct.
The COVID-19 pandemic has primarily been characterized by respiratory symptoms, but emerging evidence suggests multi-organ involvement, including the gastrointestinal tract. This case report aims to highlight colon perforation as a rare but significant complication in COVID-19 patients. We present two cases of male patients, aged 38 and 33, who were admitted with severe COVID-19 symptoms and required intubation and ventilator support. Both patients developed abdominal distension during their ICU stay, prompting surgical consultations. In the first case, a 38-year-old male developed septic shock and abdominal distension on day 29 of his hospital stay. An exploratory laparotomy revealed a 2 mm perforation in the sigmoid colon, which was managed with Hartmann's procedure. In the second case, a 33-year-old male developed abdominal distension one week post-admission. An exploratory laparotomy revealed a 2 mm perforation in the mid-transverse colon, managed initially with a primary two-layer repair and later with a transverse loop colostomy due to additional perforations. These cases emphasize the importance of maintaining a high index of suspicion for gastrointestinal complications, such as colon perforation, in COVID-19 patients. Early diagnosis and surgical intervention are crucial for managing this life-threatening complication. Further research is needed to understand the incidence and underlying mechanisms of colon perforation in COVID-19 patients.
新冠疫情主要以呼吸道症状为特征，但新出现的证据表明其会累及多器官，包括胃肠道。本病例报告旨在强调结肠穿孔是新冠患者中一种罕见但严重的并发症。我们呈现两例男性患者，年龄分别为38岁和33岁，他们因严重的新冠症状入院，需要插管和呼吸机支持。两名患者在重症监护病房住院期间均出现腹胀，因此进行了外科会诊。第一例中，一名38岁男性在住院第29天出现感染性休克和腹胀。剖腹探查发现乙状结肠有一个2毫米的穿孔，采用哈特曼手术进行处理。第二例中，一名33岁男性在入院一周后出现腹胀。剖腹探查发现横结肠中部有一个2毫米的穿孔，最初采用一期两层修复，后来由于出现额外穿孔而进行了横结肠袢式造口术。这些病例强调了对新冠患者胃肠道并发症（如结肠穿孔）保持高度怀疑的重要性。早期诊断和手术干预对于处理这种危及生命的并发症至关重要。需要进一步研究以了解新冠患者结肠穿孔的发生率和潜在机制。
