Radiology Case Reports (Nov 2020)

COVID-19 pneumonia identified by CT of the abdomen: A report of three emergency patients presenting with abdominal pain

  • Sherif Abolyazid, MD & MSc (Radiology),
  • Shireen Alshareef, SBEM & JBEM,
  • Nouf Abdullah, MD & RCPSC,
  • Abdalla Khalil, FRCGP, MRCEM (UK), Arab BIM & DTM,
  • Nashaat Hamza, MD, ABIM & ABID,
  • Ahmed Salem, Mb BCh & MSc (EM)

Journal volume & issue
Vol. 15, no. 11
pp. 2090 – 2094

Abstract

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Patients with COVID-19 infection may present to the Emergency Department (ED) with gastrointestinal complaints and no respiratory symptoms. We are presenting 3 patients who came to the ED with abdominal pain; and the computed tomography [CT] of the abdomen showed findings suggestive of COVID-19 pneumonia.A 65-year-old male patient presented with symptoms of urinary tract infection and left renal angle tenderness. A 42-year-old male patient presented with right flank pain postextracorporeal shock wave lithotripsy. A 71-year-old male known to have type 2 diabetes mellitus and who had had whipple surgery for a neoplasm of the head of the pancreas presented with a painful epigasteric swelling. The 3 patients had positive COVID-19 polymerase chain reaction (PCR) tests and mild-to-moderate illness, and were discharged home after 2 weeks with a good recovery. The first patient had a false negative early PCR test, which turned positive on 2 repetitions of the test.A systematic review of CT abdomen, including inspection of the lung bases using the lung window in all CT abdomen, is essential to detect findings suggestive of COVID-19 pneumonia in patients requiring a CT abdomen study. As proven in the literature, CT findings of COVID-19 pneumonia have a higher sensitivity than the PCR test.

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