Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Appendectomy in patient with suspected COVID-19 with negative COVID-19 results: A case report
Changho Kim, Jong Kun Kim, In Hwan Yeo, Jae Young Choe, Jeong Eun Lee, So Jeong Kang, Chan Sub Park, Ki Tae Kwon, Soyoon Hwang
Changho Kim, Jong Kun Kim, In Hwan Yeo, Jae Young Choe, Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
Jeong Eun Lee, So Jeong Kang, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, South Korea
Chan Sub Park, Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, South Korea
Ki Tae Kwon, Soyoon Hwang, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea; Department of Infection Control, Kyungpook National University Chilgok Hospital, Daegu 41944, South Korea
Author contributions: Choe JY conceived the report and is responsible for the revision of the manuscript for important intellectual content; Kim CH and Yeo IH contributed to manuscript drafting; Kim JK and Park CS analyzed and interpreted the patient data; Lee JE and Kang SJ reviewed the literature and contributed to manuscript drafting; Kwon KT and Hwang SY reviewed the literature; all authors issued final approval for the version to be submitted.
Informed consent statement: The patient provided informed consent for the publication of this case.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jae Young Choe, MD, Assistant Professor, Department of Emergency Medicine, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. choejy@hanmail.net
Received: April 17, 2020
Peer-review started: April 17, 2020
First decision: April 24, 2020
Revised: April 30, 2020
Accepted: May 16, 2020
Article in press: May 16, 2020
Published online: May 26, 2020
BACKGROUND
Even at present, we are in the middle of the novel coronavirus disease 2019 (COVID-19) pandemic and are facing challenges in trial and error. Presently, emergency surgery for patients with suspected COVID-19 is burdensome not only for patients but also for healthcare workers. Therefore, we established a surveillance system in the emergency room and established principles for managing patients suspected of COVID-19 who require emergency surgery.
CASE SUMMARY
A 67-year-old man was diagnosed with appendicitis in March 2020. His wife was diagnosed with COVID-19 10 d earlier, and the patient was in close contact with her. The patient tested negative twice on an upper respiratory COVID-19 reverse transcription–polymerase chain reaction screening test, but chest X-ray and chest computed tomography revealed patchy ground-glass opacity in both upper lobes of the patient’s lungs. The same emergency surgery procedure for patients with confirmed COVID-19 was applied to this patient suspected of having the disease to ensure that surgery was not delayed while waiting for the reverse transcription–polymerase chain reaction results. A few hours after surgery, the upper respiratory tract specimen taken in the emergency room was negative for COVID-19 but the lower respiratory tract specimen was found to be positive for the disease.
CONCLUSION
When COVID-19 is suspected, emergency surgery should be performed as for confirmed COVID-19 without delay.
Core tip: During the novel coronavirus disease 2019 (COVID-19) pandemic, if emergency surgery is required, both emergency surgery and infection control should be performed using personal protective equipment and negative-pressure equipment and facilities without waiting for the results of COVID-19 reverse transcription–polymerase chain reaction. Even if the results of the reverse transcription–polymerase chain reaction test are negative, if the medical history, symptoms, and X-ray findings indicate suspected COVID-19, all medical activities should be performed as they would for a confirmed case and samples should be repeatedly tested using various methods and at different locations.
