Acute Care Surgery in the Times of COVID-19 Pandemic: Our Experience at a Large Safety Net Hospital

Ab s t r Ac t Background: There is limited experience in managing confirmed or suspected coronavirus disease 2019 (COVID-19) patients who present for emergency general surgery. Differing presentations, diagnostic uncertainty, and lack of guidelines present challenges to surgeons taking care of these patients. Materials and methods: We present a retrospective case series of five patients (age: 20s–50s) with acute surgical emergencies, highly suspected or positive for COVID-19, providing an overview of diagnosis, management, and outcomes. Results: The first two cases were patients with acute cholecystitis and perforated duodenal ulcer with high suspicion for COVID-19 but negative reverse transcription polymerase chain reaction (RT-PCR) results. The third case was a COVID-19 confirmed patient with acute appendicitis managed nonoperatively. The last two cases were COVID-19 positive patients with lower extremity abscess and intussusception. Conclusion: Clinical decisions were made based on the urgency of each case while simultaneously navigating their COVID-19 infection status. Recognizing asymptomatic carriers, maintaining effective communication between different teams, and planning perioperative care were important aspects in achieving favorable outcomes.