IDDF2021-ABS-0153 Management of COVID positive emergencies in department of gastrointestinal surgery & management algorithm

BackgroundCovid positivity along with Gastrointestinal pathology can coexist as the most challenging emergencies in Covid time. No RCT exists in the world literature, and our experience and knowledge are enhanced by reporting results of emergency case series of surgical and nonsurgical management of GI emergencies. This can help the world over Gastrointestinal specialists in managing such cases in the covid era.MethodsTotal 8 cases included, all cases presenting as emergency also found as covid positive were included. No elective surgery performed in covid +ve cases as protocol. All patients were worked up from preoperative surgical and covid related points of view. Extreme urgent surgery was taken after covid antigen, otherwise RT PCR was awaited, HRCT chest was done in all cases. Very sick patients in whom patients covid status and chest could be optimised while keeping surgery for a later time after optimization. Covid specific treatment given was mainly oxygen anticoagulants, steroids and vitamin c.GI pathologies operated were cecal amebiasis(n=2; IDDF2021-ABS-0153 Figure 1, IDDF2021-ABS-0153 Figure 2), abdominal abscess(n=2),multiple bowel strictures(n=1; IDDF2021-ABS-0153 IDDF2021-ABS-0153 Figure 3), abdominal kochs (n=1; IDDF2021-ABS-0153 Figure 4), traumatic gut gangrene(n=1; figure 5) and nonoperative management in (n=1) severe acute pancreatitis. Affected patients were having age 86-17 and had CT severity scores of 0-17(IDDF2021-ABS-0153 Table 1). 7/8 underwent emergency surgery, no operations were performed in covid dedicated modular Operation theatre with airflow 25 per minute with all staff wearing N95 +3 ply mask or respirators (3M) and no health care worker was covid infected after operations.Abstract IDDF2021-ABS-0153 Table 1 AGE CT Sev vaccine O2 CECT ABD/DIAGNOSIS TLC D DIMER SURGERY STAY FINAL PATHOLOGY RESULT 86m 14 1 Y Sev acute pancreatitis 25000 >5000 Not operated 15d SEV acute pancreatitis ? covid induced Survived 72m 14 1 Y Cecal perforation 18000 >2500 RT COLECTOMY with colostomy 7m/f 20d Amebic cecal perforation Survived 46f 0 1 N Multiple bowel strictures 7000 5000 Bowel resection & ileostomy + m/f 20d Traumatic gangrene perf Survived 19m 0 no abd kochs 6000