COVID-19 and spontaneous esophageal perforation: a case report

Abstract

: Pulmonary manifestations of the novel coronavirus, COVID-19, have been discussed heavily in the literature, however, there have been minimal reports regarding extra-pulmonary manifestations of the disease to date. In particular, there has been no literature to date discussing the pathophysiology or incidence of esophageal perforation in the COVID-19 patient. This case report describes a 65-year-old COVID-19 positive male presenting with a case of spontaneous esophageal perforation. The patient underwent esophagogastroduodenoscopy (EGD) with stent placement followed by thoracoscopic evacuation of gastric contents from the pleural spaces and mediastinal drainage. His clinical course was unique in that his esophageal perforation management was complicated by logistical and technical challenges due to COVID-19 infection. Several precautions were required before, during and after each test or intervention performed on the patient. This created a challenging set of circumstances which had not been dealt with in the past. Nevertheless, after a two-week hospital stay, the patient was discharged in stable condition with plans for outpatient follow-up and removal of stent. This case report provides an unusual presentation of esophageal perforation in a patient with concurrent COVID-19 infection while highlighting the special techniques required to diagnose and treat the patient.