A case report on spontaneous hemoperitoneum in COVID-19 patient

Introduction: Coronavirus disease (COVID-19) is a global a 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 103 °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 are 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 the diagnosis of COVID-19 and related complications. The management of cases with unusual presentation requires judicious and careful approach.

Keywords: Acute abdomen; COVID-19; Splenic infarction; Spontaneous hemoperitoneum.