A woman with Covid had a coughing fit so severe that her intestines jumped out of her stomach.
Doctors from the University of Illinois at Chicago revealed the story in a medical case study reportand said it was the first of its kind.
The 52-year-old woman, who had an incision in her abdomen during a previous operation, was infected with the virus a few days before the incident.
The repeated coughing caused her to experience a “spontaneous abdominal evisceration,” in which the intense force of the coughing created so much pressure that her colon tore through the old surgical opening.
Doctors said in a case report that abdominal eviscerations should be considered a risk when performing surgeries on patients who are or become Covid-positive (stock image)
The patient was rushed to the hospital, where doctors noticed several centimeters of intestine protruding from her lower left abdomen.
They were able to clean out the intestines, put them back into her body and close her wound better.
While the authors wrote that this complication is rare, they said doctors should consider a patient’s COVID status before performing surgery.
Doctors wrote in the report that the woman had undergone surgery 13 years earlier for a hernia in her abdomen, a rupture in which an organ pushes through muscle or tissue.
Shortly after, she was incarcerated and had to undergo several repairs to her original surgery over the years.
Five days before her strange injury, the woman contracted COVID and experienced coughing fits.
When she arrived at the hospital after a violent coughing fit, doctors saw her intestine protruding from the wound from her previous hernia operation.
The illustration on the left is from a case report of a patient from Florida, showing the man’s intestines coming out of the wound in his abdomen. The illustration on the right shows the man’s incision after doctors had repaired his evisceration
The report’s authors did not provide further details about the woman’s condition, but did write that she required resuscitation.
She was also given antibiotics to prevent infection of the exposed bowel.
The woman was then taken to the operating room, where doctors examined her intestines, flushed them out and put them back into her body.
To close the wound, surgeons used multiple sutures over multiple layers of the woman’s abdominal fat, tissue and skin, using a very strong suturing technique that can withstand increased tension in the body.
Surgeons were able to successfully place the woman’s organs back into her body and close her wound
The surgery was successful and the woman’s bowel function remained intact. There were no further complications and she was discharged home after six days in the hospital.
Abdominal evisceration is a rare but serious complication of surgery. Sometimes called disembowelment, it occurs when a patient’s internal organs protrude through an incision due to wound dehiscence, the reopening of a surgical site.
a study It is estimated that wound dehiscence occurs in up to three in every 100 people who have had abdominal or pelvic surgery, but it may also occur in up to 10 percent of older patients.
For four out of ten patients it can be fatal due to excessive blood loss, persistent severe pain or damage to exposed organs.
Experts cite cough as a major risk factor for the complication, and the authors of the case report wrote that “postoperative cough is a known risk factor for fascial dehiscence and evisceration,” which carries a high mortality rate and is associated with an increase in future complications.
When there is wound dehiscence and evisceration, this must be treated surgically. In this procedure, organs are replaced in the abdomen and the open wound is closed.
Sterile saline solution must also be applied to the removed organs to keep the exposed organs moist until the surgery can be performed.
The surgeons added: ‘As new variants of Covid-19 continue to emerge, new clinical presentations of Covid-19 are being seen. Although evisceration is a rare presentation, surgeons should be aware of the possibility and consider it when performing surgery on patients with Covid-19.
While the case study authors report that this is the first known incident of abdominal evisceration in a patient with Covid-19, a man in Florida recently suffered a similar injury.
Doctors wrote in a May 2024 case report that a man who recently underwent abdominal surgery had his intestines protruding from the incision after he coughed and sneezed simultaneously while eating breakfast at a restaurant with his wife.
The 63-year-old noticed a “wet” feeling, followed by sharp pain. When he lifted his shirt, he saw inches of intestine protruding from his surgical wound.
He was immediately taken to the operating room, where surgeons were able to successfully place his intestines back into his abdomen.
After six days of recovery in the hospital, the man was sent home with no further complications.