Acute surgical abdomen during the COVID-19 pandemic: a retrospective study on clinical and therapeutic challenges

Abstract

Background As with other medical specialties throughout the epidemic, general surgical clinics’ treatment protocols have changed because of the COVID-19 pandemic, which has become a serious danger to healthcare systems. The presence of severe COVID-19 in young individuals and among medical workers has exacerbated the psychological burden on clinicians treating patients suspected of having or being infected with SARS-CoV-2, even if comorbidities and older age are statistically linked to higher death rates. Patients and methods A retrospective comparative study included patients who were admitted to the emergency room (ER), surgical, or managing conservatory for acute surgical abdomen. All subjects were divided into three groups. 1186 patients; out of them, 490 cases were examined before the pandemic, 334 cases were examined during the pandemic, and 362 cases were examined after vaccination. Results Before the pandemic, the commonest cause of acute abdomen was appendicitis (21.8%), strangulated hernia (21%), and cholecystectomy (17.8%). During the pandemic, the commonest cause of acute abdomen was appendicitis (21.8%), cholecystectomy (16.8%), and Mesenteric venous occlusion (MVO)/Mesenteric Artial occlusion (MAO) (13.8%). After the pandemic, the commonest causes of acute abdomen were cholecystectomy (25.4%), appendicitis (24.6%), and exploration abdomen (11.9%). The time of management differed significantly among the studied groups. The highest requirement for immediate intervention was attributed to the before pandemic group, while during the pandemic group was associated with conservative management, and after conservative management. Conclusion The Sars-Cov-2 pandemic highly affected the clinical presentation, aetiology, diagnostic and paraclinical investigations, and therapeutic management, as well as the changes in emergency practice procedures.