Dengue fever may mislead the surgeons when it presents as an acute abdomen
10.1016/j.apjtm.2016.12.010
- Author:
Bingumal JAYASUNDARA
1
;
Lalith PERERA
1
;
Ajith DE SILVA
1
;
Bingumal JAYASUNDARA
2
;
Lalith PERERA
2
Author Information
1. Department of General Surgery, National Hospital of Sri Lanka
2. Department of General Surgery, Colombo South Teaching Hospital
- Publication Type:Journal Article
- Keywords:
Acute abdomen;
Acute cholecystitis;
Appendicitis;
Dengue hemorrhagic fever
- From:
Asian Pacific Journal of Tropical Medicine
2017;10(1):15-19
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). Methods Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered. Results Out of the seventeen cases (7 males, age range 10–71 years) presented with fever and AA; appendicitis, cholecystitis, pancreatitis and non-specific peritonitis were suspected initially in 8, 5, 1 and 3 cases, respectively. Neutropenia or thrombocytopenia signifying DF/DHF occurred only in 11 patients at first evaluation thus six remained as surgical candidates beyond 24 h. One patient underwent appendicectomy with a prolonged hospital stay. DF was confirmed by serology in all patients, latest by fourth day of admission. One required blood product transfusion, 4 needed critical care treatment and there was 1 death. Conclusions DF/DHF misleads the clinicians when it presents as AA. Initial hematological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma. Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas, to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.
