Journal of Emergency Practice and Trauma

A study on abdominal emergencies presenting during COVID-19 at a tertiary care center in Central India

Document Type : Original Article

Authors

Vishnu Vardhan P. Reddy 1
Srujan Dharap 1
Reyaz Ahmad 2
Ajeet Pratap Maurya 1
Meena Kumari 1
Bharati Pandya 1

1 Department of General Surgery, All India Institute of Medical Sciences, Bhopal, India

2 Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhopal, India

https://doi.org/10.34172/jept.2024.17
Abstract
Objective: COVID-19 caused one of the most prolonged global pandemics, disturbing the routine of hospital protocols beyond measure, especially affecting surgical specialties, emergencies, and cancer care.
Methods: This observational study was conducted on 129 patients of pediatric and adult age groups who presented with abdominal emergencies from March 1, 2020 to March 31, 2022 and were recruited for the study from the department of General Surgery, All India Institute of Medical Sciences, Bhopa. The analysis done using the chi-square or Fisher’s exact test. P values < 0.05 were considered significant. The outcomes were compared with the pre-existing standard protocols using SPSS.
Results: Among the 129 patients, 104 were COVID-19-negative and 15 were COVID-19-positive, and in 10 cases, the results were inconclusive. The abdominal presentations observed in the study were as follows: two patients with hemorrhagic and five with septic shock. Emergency surgeries were done in 80 (62.1%) patients, and conservative approaches were used in 49 (37.9%) patients; of the 80 patients who underwent operation, 30 (37.5%) required deviation from standard established protocols. The ICU admitted a larger number of COVID-19-positive patients as compared to COVID-19-negative patients [8 (57%) vs. 24 (25%)] who needed operations, and 18 (13.9%) patients were treated conservatively in the ICU. Mortality was higher in COVID-19-positive as compared to COVID-19-negative patients [4 (28%) vs. 9 (8%)].
Conclusion: The present study demonstrated the definite negative impact of COVID-19 on emergencies but provided useful lessons for emergency surgeons. A high standard of care, such as evaluating if a procedure can be postponed till the patient is less infectious or at a lesser risk of morbidity and mortality, is warranted during COVID-19 or similar pandemics. Ensuring adequate safety measures in the operating theatre is essential. We recommend a careful and judicious evaluation of every surgical indication.

Keywords

COVID-19
RT-PCR
SARS CoV-2
Acute abdomen
Mesenteric ischemia
Subjects
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Journal of Emergency Practice and Trauma
Volume 10, Issue 1
January 2024
Pages 7-16

  • Receive Date 13 November 2023
  • Revise Date 02 February 2024
  • Accept Date 27 February 2024

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