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Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma?
BACKGROUND: The COVID-19 pandemic started to affect Turkey in March 2020. In this study, we retrospectively investigated spontaneous rectus sheath hematoma (S-RSH) in patients with COVID-19 presenting with acute abdominal pain during the ongoing pandemic. METHODS: The demographic characteristics, la...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kare Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493841/ https://www.ncbi.nlm.nih.gov/pubmed/35775687 http://dx.doi.org/10.14744/tjtes.2022.85681 |
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author | Özer, Mehmet Gökay Terzioğlu, Serdar Yağız, Betül Keskinkılıç Gürer, Ahmet Dinç, Tolga Coşkun, Ali |
author_facet | Özer, Mehmet Gökay Terzioğlu, Serdar Yağız, Betül Keskinkılıç Gürer, Ahmet Dinç, Tolga Coşkun, Ali |
author_sort | Özer, Mehmet |
collection | PubMed |
description | BACKGROUND: The COVID-19 pandemic started to affect Turkey in March 2020. In this study, we retrospectively investigated spontaneous rectus sheath hematoma (S-RSH) in patients with COVID-19 presenting with acute abdominal pain during the ongoing pandemic. METHODS: The demographic characteristics, laboratory findings, length of hospital stay, and treatment processes of COVID-19 cases with S-RSH detected between March and December 2020 were recorded. The rectus sheath hematoma diagnosis of the patients was made using abdominal computed tomography, and the patients were followed up. Low-molecular-weight heparin treatment, which was initiated upon admission, was continued during the follow-up. RESULTS: S-RSH was detected in 13 out of 220 patients with COVID-19 who were referred to general surgery for consultation due to acute abdominal pain. The mean age of these patients was 78±13 years, and the female-to-male ratio was 1.6. Mechanical ventilation support was applied to three patients, all of whom were followed up in the intensive care unit. Two patients died for reasons independent of rectus sheath hematoma during their treatment. Among the laboratory findings, the activated partial thromboplastin time (aPTT) values did not deviate from the normal range. While there was no correlation between the international normalized ratio (INR) and aPTT (p>0.01), a significant correlation was found between INR and interleukin-6 (IL-6) (p<0.002). None of the patients required surgical or endovascular interventional radiology procedures. CONCLUSION: In the literature, the incidence of S-RSH in patients presenting with acute abdominal pain is 1.8%. However, in our series, this rate was approximately 3 times higher. Our patients’ normal INR and aPTT values suggest that coagulopathy was mostly secondary to endothelial damage. In addition, the significantly higher IL-6 values (p<0.002) indicate the development of vasculitis along with the acute inflammatory process. S-RSH can be more commonly explained the high severity of vasculitis and endothelial damage due to viral infection. |
format | Online Article Text |
id | pubmed-10493841 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Kare Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-104938412023-09-12 Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? Özer, Mehmet Gökay Terzioğlu, Serdar Yağız, Betül Keskinkılıç Gürer, Ahmet Dinç, Tolga Coşkun, Ali Ulus Travma Acil Cerrahi Derg Original Article BACKGROUND: The COVID-19 pandemic started to affect Turkey in March 2020. In this study, we retrospectively investigated spontaneous rectus sheath hematoma (S-RSH) in patients with COVID-19 presenting with acute abdominal pain during the ongoing pandemic. METHODS: The demographic characteristics, laboratory findings, length of hospital stay, and treatment processes of COVID-19 cases with S-RSH detected between March and December 2020 were recorded. The rectus sheath hematoma diagnosis of the patients was made using abdominal computed tomography, and the patients were followed up. Low-molecular-weight heparin treatment, which was initiated upon admission, was continued during the follow-up. RESULTS: S-RSH was detected in 13 out of 220 patients with COVID-19 who were referred to general surgery for consultation due to acute abdominal pain. The mean age of these patients was 78±13 years, and the female-to-male ratio was 1.6. Mechanical ventilation support was applied to three patients, all of whom were followed up in the intensive care unit. Two patients died for reasons independent of rectus sheath hematoma during their treatment. Among the laboratory findings, the activated partial thromboplastin time (aPTT) values did not deviate from the normal range. While there was no correlation between the international normalized ratio (INR) and aPTT (p>0.01), a significant correlation was found between INR and interleukin-6 (IL-6) (p<0.002). None of the patients required surgical or endovascular interventional radiology procedures. CONCLUSION: In the literature, the incidence of S-RSH in patients presenting with acute abdominal pain is 1.8%. However, in our series, this rate was approximately 3 times higher. Our patients’ normal INR and aPTT values suggest that coagulopathy was mostly secondary to endothelial damage. In addition, the significantly higher IL-6 values (p<0.002) indicate the development of vasculitis along with the acute inflammatory process. S-RSH can be more commonly explained the high severity of vasculitis and endothelial damage due to viral infection. Kare Publishing 2022-07-01 /pmc/articles/PMC10493841/ /pubmed/35775687 http://dx.doi.org/10.14744/tjtes.2022.85681 Text en Copyright © 2022 Turkish Journal of Trauma and Emergency Surgery https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License |
spellingShingle | Original Article Özer, Mehmet Gökay Terzioğlu, Serdar Yağız, Betül Keskinkılıç Gürer, Ahmet Dinç, Tolga Coşkun, Ali Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? |
title | Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? |
title_full | Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? |
title_fullStr | Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? |
title_full_unstemmed | Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? |
title_short | Does COVID-19 increase the incidence of spontaneous rectus sheath hematoma? |
title_sort | does covid-19 increase the incidence of spontaneous rectus sheath hematoma? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493841/ https://www.ncbi.nlm.nih.gov/pubmed/35775687 http://dx.doi.org/10.14744/tjtes.2022.85681 |
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