An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS* 

A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical community:

Lack of taste and smell:

A minority of patients present with decreased sense of taste and/or smell as their first symptom. This can precede any other symptom. Several ENT physicians have been exposed to Covid-19 because they unsuspectingly examined these patients in their offices

Abdominal Pain:

A minority of patients can present with abdominal pain and possible associated fever. In some instances, even mimicking appendicitis. They usually have accompanying diarrhea, loss of appetite and or vomiting. When the clinical presentation of a suspected acute abdominal diagnosis appears somewhat atypical, including only mildly raised WBC or CRP, a CT of the abdomen including the chest can be paramount to avoid taking the patient to surgery.

Chest Ultrasound:

As the number of patients increases, a useful diagnostic modality could be thoracic ultrasound. Six areas of the thorax are studied at each side. Please follow this link to see a 5 minute video of how to perform a diagnostic ultrasound or watch it below, courtesy of San Matteo Hospital, Pavia, Italy –

Testing:

There is a wide range of sensitivity and wait times for results of the Covid-19 diagnostic test. The provider swabbing the patient should know how to do it correctly and has the experience in doing it. A superficial, incorrect swabbing is discouraged since it may lead to a false negative result.

Participants:

Drs. Horacio Asbun (Lead), Mohammed Abu Hilal, Jaap Bonjer, Nicolas Demartines, Ho-Seong Han, Salvador Morales, Andrea Pietrabissa, Aurora Pryor, Christopher Schlachta, Eduardo Targarona

Other Surgical Societies/leaders are welcome to participate in future discussions. Please contact SAGES Executive Director, Sallie Matthews at sallie@sages.org if interested in being considered for participation.

*GENERAL DISCLAIMER:  

The following is intended to provide our members with information arising from the experience of our colleagues from Europe and Asia who experienced the pandemic first.  While the information provided is from very reliable sources, it is NOT evidence based data, since there was no time to test its validity on scientific grounds. It is merely an attempt to share practical advice based upon prior experience and current knowledge.