A Thought-provoking Experience of Surgical Treatment for a Patient with Sepsis Secondary to Stercoral Rectal Perforation, with Concomitant COVID-19

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  • 新型コロナウイルス感染症合併直腸穿孔の1例
  • シンガタ コロナウイルス カンセンショウ ガッペイ チョクチョウ センコウ ノ 1レイ

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Abstract

<p>Herein, we present a successfully treated case of a patient with sepsis due to stercoral rectal perforation, with concomitant novel corona virus disease (COVID-19). A 79-year-old woman visited an advanced emergency hospital with complaints of abdominal pain and fever. However, it was in the initial phase of the COVID-19 outbreak, hospitals were overwhelmed, and she could not undergo surgery. She was referred to our regional hospital for appropriate therapy, including palliative care. At first, we attempted to stabilize her general condition by conservative, but intensive treatments. Next, she was released from intentional isolation according to the Japanese guideline for COVID-19 treatment. Finally, we created a colostomy by the laparoscopic approach. She was discharged from our hospital in accordance with the Japanese guideline for hospital discharge, although her postoperative course, including prolonged fever, added confusion to making clinical decisions. In the COVID-19 pandemic era, the aspects of safety, feasibility and concerns in relation to surgical treatments have been discussed, especially in patients suffering from COVID-19 concomitantly with other infectious diseases. Real-time monitoring, e.g., by repeated rapid antigen tests, could be a valuable tool for determining the optimal timing for surgical treatments.</p>

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