Webinar #21 | “Barado at Sarado: Gut Obstruction During the Time COVID-19?”

TVUP

The University of the Philippines
in partnership with
Philippine Health Insurance Corporation (PhilHealth) and
UP Manila NIH National Telehealth Center
in cooperation with
UP Manila College of Medicine and
UP Philippine General Hospital
would like to invite you to join the Fight Against COVID-19!

The Webinar Series “STOP COVID DEATHS: VIRTUAL GRAND ROUNDS”
– the very first Online Medicine Grand Rounds in the Philippines-
is scheduled EVERY FRIDAY from 12nn to 2pm.

Webinar #21:
“Barado at Sarado: Gut Obstruction During the Time COVID-19?”
Dr. Brent Viray
Senior Resident, Department of Surgery
Philippine General Hospital
September 11, 2020 (Friday) 12nn

Discussant: Dr. Hermogenes Monroy
Chief, Division of Colorectal Surgery
Department of Surgery, Philippine General Hospital
Reactors:
Dr. Orlando Ocampo
Head, PGH COVID Response Task Force
Chief, Division of Trauma
Department of Surgery, Philippine General Hospital
Cecilia G. Peña
Deputy Director for Nursing, Philippine General Hospital

Case Capsule: A 47 year-old female with a history of Crohn’s Disease experiences bloating, vomiting and diarrhea. She tries to consult at emergency rooms, but is unsuccessful due to the case load from COVID-19. After two weeks, she is finally admitted at a local hospital and a nasogastric tube is inserted for bowel decompression. Chest x-ray is taken on the 5th day of admission – suggesting hospital acquired pneumonia. She is referred to the Philippine General Hospital where emergency surgery is scheduled. The team is not aware that she was a suspect COVID case, nevertheless – a swab was taken at the emergency room.
Acute intestinal obstruction occurs when there is an interruption in the forward flow of intestinal contents. Intestinal obstruction is most commonly caused by intra-abdominal adhesions, malignancy, or intestinal herniation. Clinically patients have nausea and vomiting, colicky abdominal pain, and a failure to pass flatus or bowel movements. Management of uncomplicated obstructions includes fluid resuscitation with correction of metabolic derangements, intestinal decompression, and bowel rest. Complications of intestinal obstruction include bowel ischemia and perforation and could result in death if not managed surgically and in a timely manner. This is a case of partial gut obstruction, with delayed diagnosis and suspected COVID-19 infection.