A case report on spontaneous hemoperitoneum in COVID-19 patient

Karki, Saurab; Rawal, Sushil Bahadur; Malla, Srijan; Rayamajhi, Jyoti; Thapa, Bikash Bikram

INTRODUCTION: Corona virus disease (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients commonly present with respiratory tract symptoms and fever. However two third are asymptomatic and unusual presentation is evolving. This has cause management dilemma among physicians. PRESENTATION OF CASE: A 35 year young otherwise healthy male presented to emergency department of this institute with fever of 103o F, abdominal pain, and pancytopenia with progressive fall in hemoglobin level was tested positive for COVID-19. Contrast enhance computed tomography of the patient revealed hemoperitoneum with splenic infarct. He was admitted in intensive care unit and managed with supportive treatment. DISCUSSION: Respiratory and gastrointestinal symptoms with hematological abnormalities like lymphopenia, thrombocytopenia were common presentation of COVID-19. Although coagulopathy and vasculitis has been a well-documented entity in patients with COIVD-19, visceral infarction leading to spontaneous hemoperitoeum was unusual and rare clinical presentation. CONCLUSION: A high degree of clinical suspicion and thorough evaluation helps in diagnosis of COVID-19 and related complications. The management of cases with unusual presentation requires judicious and careful approach.