Diaphragmatic Rupture and Gastric Perforation in a Patient with COVID-19 Pneumonia

Authors

• Erika Poggiali Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
• Andrea Vercelli Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
• Elena Demichele Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
• Eva Ioannilli Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
• Andrea Magnacavallo Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy

erikapoggiali2@gmail.com

Keywords

Abstract

We describe the case of a young female patient admitted to our emergency department during the Italian COVID-19 epidemic, for fever and dry cough associated with symptoms of gastric reflux over the previous 5 days. Lung ultrasound showed diffuse bilateral B lines with irregular pleural thickening, and consolidation with air bronchogram and slight pleural effusion in the lower left lobe. Chest HRCT and abdominal CT scanning with contrast revealed diaphragmatic rupture with gastric perforation, and atelectasis of the left pulmonary lobe with unilateral pleural effusion, diffuse ground-glass opacities and multiple small consolidations in both lobes. A nasopharyngeal swab for 2019-nCoV was positive. A diagnosis of diaphragmatic rupture and gastric perforation in COVID-19 pneumonia was made. The patient was immediately hospitalized and surgically treated. Treatment for COVID-19 and empiric antibiotic therapy were promptly started.