Case report: Colon ischemia and perforation as a result of Norovirus infection. (January 2021)

• Record Type: Journal Article
• Authors: Beredjiklian, C.M.; Olf, M.; Abusaman, A.; Becker, R.; Jonescheit, J.
• Is Part Of: International journal of surgery case reports. Volume 78(2021)
• Page Start: 85
• Page End: 87
• Publication Date: 2021-01
• Subjects: Norovirus infection -- Bowel perforation -- Pneumatosis intestinalis -- Colon ischemia -- Bowel resection -- Diarrhoea; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.11.130
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Atypical Norovirus infection symptoms and course. Unusual diagnostics with CT findings: ischemia, pneumatosis intestinalis and perforation. Surgical Procedure: Resection with good surgical outcome. First case of its kind in Germany, first recommendations of how to approach atypical Norovirus infection. Abstract: Introduction: Norovirus (NoV) gastroenteritis has been documented as the worldwide leading cause of the majority of acute cases of viral gastroenteritis. Here, we present a Case of NoV that progressed into colon perforation. Presentation of case: A 47-year-old woman was admitted via the emergency unit with diarrhoea, lower abdominal pain, vomiting and fever. The virological testing of her stool revealed a NoV infection. The abdominal CT scan showed massive pneumatosis intestinalis. Following the scan findings, the patient was admitted for a diagnostic laparotomy the same day. A side-to-side ileosigmoidostomy was performed. We performed two clinical re-evaluations of the patient, the first one took place 2 weeks after we discharged the patient and another one-year later. The patient is in perfect health. Discussion: To the best of our knowledge and following a thorough bibliographical search, this is the first case report in Germany and the first case report of colon perforation due to NoV infection in adults in the European Union. Conclusion: A NoV infection could, along with the typical symptoms, indicate a life-threatening bowel ischemia and/or necrosis.