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

Abolyazid, Sherif; Alshareef, Shireen; Abdullah, Nouf; Khalil, Abdalla; Hamza, Nashaat; Salem, Ahmed

Patients with COVID-19 infection may present to the Emergency Department (ED) with gastrointestinal complaints and no respiratory symptoms. We are presenting three patients who came to the ED with abdominal pain; and the 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 post– extracorporeal 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 three patients had positive COVID-19 polymerase chain reaction (PCR) tests and mild to moderate illness, and were discharged home after two weeks with a good recovery. The first patient had a false negative early PCR test, which turned positive on two 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.