A pregnant woman with uncommon symptoms and complications of covid19: Case report

Document Type : Case report

Authors

1 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

2 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

3 Medical Student, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

4 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

5 Assistant professor, Department of Surgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: The most common signs and symptoms of the novel coronavirus disease which causes severe acute respiratory syndrome include: fever, dry cough, dyspnea and myalgia. But the remarkable point is that half of the patients with this infection have digestive symptoms. In this study, a case of covid-19 with atypical symptoms is reported.
Case presentation: A 24-year-old pregnant woman with generalized abdominal pain, bloat and losing appetite without respiratory signs referred to Akbarabadi hospital. Regarding to the epidemic of covid-19 and febrile of the mother after 20 hours, PCR test was done and the result was positive. Emergency appendectomy was done obliquely through a McBurneys point. Pathological results confirmed perforated appendicitis.
Conclusion: Since now coronavirus infection is a pandemic, PCR test should be considered for patients with no typical symptoms, but they have acute digestive symptoms; because in the present case with covid-19, appendicitis progressed rapidly and increased maternal morbidity and complications.

Keywords

References

  1.  

    1. Ahn DG, Shin HJ, Kim MH, Lee S, Kim HS, Myoung J, et al. Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19). J Microbiol Biotechnol 2020;30(3):313-324.
    2. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41(2):145-151.
    3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506.
    4. Pan L, Mu M, Yang P, Sun Y, Wang R, Yan J, et al. Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study. Am J Gastroenterol 2020;115(5):766-773.
    5. Yuk JS, Kim YJ, Hur JY, Shin JH. Association between pregnancy and acute appendicitis in South Korea: a population-based, cross-sectional study. J Korean Surg Soc 2013;85(2):75-9.
    6. Snyder MJ, Guthrie M, Cagle S. Acute Appendicitis: Efficient Diagnosis and Management. Am Fam Physician 2018;98(1):25-33.
    7. Franca Neto AH, Amorim MM, Nóbrega BM. Acute appendicitis in pregnancy: literature review. Rev Assoc Med Bras (1992) 2015; 61(2):170-7ل
    8. Han C, Duan C, Zhang S, Spiegel B, Shi H, Wang W, et al. Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. Am J Gastroenterol2020;115(6):916-923.
    9. Abdalhadi A, Alkhatib M, Mismar AY, Awouda W, Albarqouni L. Can COVID 19 present like appendicitis?. IDCases 2020;21:e00860.
    10. Pautrat K, Chergui N. SARS-CoV-2 infection may result in appendicular syndrome: Chest CT scan before appendectomy. J Visc Surg 2020;157(3S1):S63-S64.
    11. Vu D, Ruggiero M, Choi WS, Masri D, Flyer M, Shyknevsky I, et al. Three unsuspected CT diagnoses of COVID-19. Emerg Radiol. 2020 Jun;27(3):229-232.
    12. Aptilon Duque G, Mohney S. Appendicitis in Pregnancy. [Updated 2020 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551642/
    13. Evrimler S, Okumuser I, Unal N. Computed Tomography (CT) Findings of a Diagnostic Dilemma: Atypically Located Acute Appendicitis. Pol J Radiol 2016;81:583-588.
    14. Schwulst SJ, Son M. Diagnostic Imaging in Pregnant Patients With Suspected Appendicitis. JAMA 2019;322(5):455-456.
    15. Ludwig DR, Tsai R, Raptis DA, Mellnick VM. MRI evaluation of the pregnant patient with suspected appendicitis: imaging considerations and alternative explanations for abdominal and pelvic pain. InEmergency Imaging of Pregnant Patients 2020:87-109.
    16. Wilms IM, de Hoog DE, de Visser DC, Janzing HM. Appendectomy versus antibiotic treatment for acute appendicitis. Cochrane Database Syst Rev 2011; (11):CD008359.
    17. Tinoco-González J, Rubio-Manzanares-Dorado M, Senent-Boza A, Durán-Muñoz-Cruzado V, Tallón-Aguilar L, Pareja-Ciuró F, et al. Acute appendicitis during pregnancy: differences in clinical presentation, management, and outcome. Emergencias 2018;30(4):261-264.
    18. Lee SH, Lee JY, Choi YY, Lee JG. Laparoscopic appendectomy versus open appendectomy for suspected appendicitis during pregnancy: a systematic review and updated meta-analysis. BMC Surg 2019;19(1):1-2.
    19. Farrokh D, Feyzi A, Fallah Rastegar Y, Boloursaz S. Ultrasound in the differential diagnosis of acute appendicitis. Journal of North Khorasan University of Medical Sciences 2016; 8(2):321-30.
    20. Kave M, Parooie F, Salarzaei M. Pregnancy and appendicitis: a systematic review and meta-analysis on the clinical use of MRI in diagnosis of appendicitis in pregnant women. World Journal of Emergency Surgery 2019; 14(1):1-4.
    21. Orthopoulos G, Santone E, Izzo F, Tirabassi M, Pérez-Caraballo AM, Corriveau N, et al. Increasing incidence of complicated appendicitis during COVID-19 pandemic. Am J Surg 2020:S0002-9610(20)30595-X.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 11
January 2021
Pages 106-111

Files

Share

How to cite

Statistics