Gastrointestinal symptoms - CT chest added

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Clinical information

  • 40-year-old male
  • Generally unwell with 1 week history of myalgia
  • 1 day of fevers and abdominal pain
  • Right iliac fossa tenderness
  • Clinically suspected appendicitis
  • (On direct questioning admitted to occasional coughing and minor shortness of breath on exertion)

Gastrointestinal symptoms - CT chest added

  • An abdominal CT was requested (not shown - no cause of abdominal pain was demonstrated on CT)
  • Even though suspicion of COVID-19 infection was low, a CT chest was added to the request for CT abdomen
  • Multiple foci of patchy ground glass opacification are present in all areas of the lungs
  • The chest X-ray taken earlier the same day was reviewed (see below)
  • Note: Gastrointestinal symptoms (pain, vomiting, diarrhoea) are the dominant symptoms in approximately 5% of patients with COVID-19

Review of Chest X-ray

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Review of Chest X-ray

  • Minor patchy shadowing is present in the right lower zone
  • Other areas of the lungs appeared normal despite the changes seen on CT
  • He tested swab positive later the same day
  • Classification: Mild
  • Note: Chest X-rays can underestimate the extent of disease, so any lung shadowing is likely to be significant in the context of clinically suspected COVID-19 pneumonia

Page author: Salisbury NHS Foundation Trust UK (Read bio)

Last reviewed: May 2020