Open AccessSpontaneous Pneumothorax Mimicking Perforated Viscus in Covid-19 patient
Author(s) -
MOHD SHAHIMIN SOAID,
Nor’izah Ahmad
Publication year - 2021
Publication title -
british journal of surgical science
Language(s) - English
Resource type - Journals
ISSN - 2754-8880
DOI - 10.54323/bjoss.2021.7
Subject(s) - pneumomediastinum , medicine , subcutaneous emphysema , pneumothorax , pneumoperitoneum , laparotomy , surgery , respiratory distress , chest tube , intubation , perioperative , mediastinal emphysema , abdomen , radiology , respiratory failure , laparoscopy
Case presentation: A 65-year-old female diagnosed with COVID-19 developed worsening respiratory distress requiring invasive ventilation. Chest radiography post-intubation revealed air under the diaphragm, pneumomediastinum and subcutaneous emphysema. The case was referred to the surgical team for emergency laparotomy for suspected perforated viscus. Clinically, her abdomen was distended but there was no sign of peritonism. In view of the high risk of perioperative morbidity and absence of peritonism, a CT scan was done to rule out the cause of pneumoperitoneum. CT scan showed bilateral pneumothorax, presence of air in the extra peritoneum and retroperitoneum. There was no air in the peritoneum and no evidence of perforated viscus. She was treated conservatively with bilateral chest tube insertion. Unfortunately, she developed multiorgan failure and succumbed to death.