Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1944
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
Processing time: 37 Days and 19 Hours
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.
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.
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.