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  • Combination of ectopic pancreas and intestinal malrotation presenting as non-specific right iliac fossa pain in a SARS-CoV-2 positive patient

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Case report
Combination of ectopic pancreas and intestinal malrotation presenting as non-specific right iliac fossa pain in a SARS-CoV-2 positive patient
  1. Woochan Hwang1,
  2. Kristof Nemeth1,
  3. Annabelle White1 and
  4. Luca Bonomo1,2,3
  1. 1General Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2General Surgery, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
  3. 3Honorary Lecturer, King's College London, London, UK
  1. Correspondence to Dr Woochan Hwang; woochan.hwang{at}gstt.nhs.uk

Abstract

We describe the case of a 31-year-old man who presented with a 3-day history of right iliac fossa pain with associated nausea and vomiting. He denied any previous incidents of abdominal pain and had no relevant medical history or family history to note. Given the typical history, examination findings of localised peritonism and infection risk, he was taken to theatre for laparoscopic appendicectomy without diagnostic imaging. Intraoperatively, we noted gut malrotation and an inflammatory jejunal mass which was resected after converting to a mini-laparotomy. The inflammatory mass was reported to be an ectopic pancreatic tissue from histology. Given that this patient had tested positive for SARS-CoV-2 on admission, we propose a possible case of SARS-CoV-2 infection triggering inflammation of the ectopic pancreatic tissue.

  • gastrointestinal surgery
  • pancreatitis
  • COVID-19

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-241926

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    Footnotes

    • Contributors WH, KN, AW and LB were directly involved in the care of the patient and in writing the case report. LB was the consultant responsible for the patient.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.