Evaluation of emergency general surgery operations in COVID-19 patients in a pandemic hospital: a single center experience


  • İsmail Hasirci Department of General Surgery, City Hospital, Health of Sciences University, Konya, Turkey
  • Mehmet E. Ulutas Department of General Surgery, City Hospital, Health of Sciences University, Konya, Turkey
  • Gurcan Simsek Department of General Surgery, City Hospital, Health of Sciences University, Konya, Turkey
  • Alpaslan Sahin Department of General Surgery, City Hospital, Health of Sciences University, Konya, Turkey
  • Kemal Arslan Department of General Surgery, City Hospital, Health of Sciences University, Konya, Turkey
  • Mehmet A. Eryilmaz Department of General Surgery, City Hospital, Health of Sciences University, Konya, Turkey




Emergency surgery, COVİD-19, Pandemic


Background: During the pandemic, the decision on delaying elective surgeries was implemented country-wide, and emergency surgeries were excluded from this scope. In this study, the patients diagnosed with COVID-19 and who underwent an emergency general surgery operation were evaluated regarding indications, demographic characteristics, and preoperative and postoperative clinical features.

Methods: In the study, emergency surgeries performed by the department of general surgery between 1st June and 30th September, when our center cared only patients diagnosed with COVID-19, were reviewed retrospectively.

Results: A total of 13 patients, 7 women and 6 men, were included in this study. The most common surgical diagnosis was acute appendicitis (9/13). For all of the patients with appendicitis, a conventional appendectomy procedure was performed. 2 patients were diagnosed with an incarcerated femoral hernia and then operated (2/13). One patient was operated on due to a sharp object injury, and one due to an acute abdomen caused by a perforation. Only 3 of the operated patients developed postoperative wound site complications (23%). No mortality was observed by the end of a 15-day follow-up.

Conclusions: The most common cause of emergency surgeries during the pandemic, changelessly, remains to be acute appendicitis. Besides, cases of trauma, perforated peptic ulcer, and incarcerated hernia are also commonly encountered. While the pandemic continues full steam, these conditions that are associated with the pandemic but among causes of mortality and morbidity other than COVID-19 and that may require an emergency surgery should be considered. All emergency surgical procedures should continue to be performed punctually by using necessary protective types of equipment.


ACS. About the Coronavirus Disease 2019 (COVID-19) 03-22-2020. Available at: https://www.facs.org /about-acs/covid-19. Accessed 25 March 2020.

McLean RC, Young J, Musbahi A, Lee JX, Hidayat H, Abdalla N et al. A single-centre observational cohort study to evaluate volume and severity of emergency general surgery admissions during the COVID-19 pandemic: is there a “lockdown” effect? Int J Surg. 2020;83:259-66.

Intercollegiate General Surgery Guidance on COVID-19. 2020. Available at: https://www. rcsed.ac.uk/news-public-affairs/news/2020/march/ intercollegiate-general-surgery-guidance-on-covid-19. Accessed 25 March 2020.

Yu GY, Lou Z, Zhang W. Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China. Zhonghua Wei Chang Wai Ke Za Zhi. 2020;23(3):9-11.

Orthopoulos G, Fernandez GL, Dahle JL, Casey E, Jabbour N. Perioperative considerations during emergency general surgery in the era of COVID-19: a US experience. J Laparoendoscopic Adv Surg Tech. 2020;30(5):481-4.

Coimbra R, Edwards S, Kurihara H, Bass GA, Balogh ZJ, Tilsed J et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Euro J Trauma Emergency Surg. 2020;46(3):505-10.

Morris SN, Fader AN, Milad MP, Dionisi HJ. Understanding the scope of the problem: why laparoscopy is considered safe during the COVID-19 pandemic. J Minim Invasive Gynecol. 2020;27(4):789-91.

Yeo C, Yeo D, Kaushal S, Ahmed S. Is it too premature to recommend against laparoscopic emergency surgery in COVID-19 patients? J Brit Surg. 2020;107(7):e202-2.

Brücher BL, Nigri G, Tinelli A, Lapeña JFF, Espin-Basany E et al. COVID-19: Pandemic surgery guidance. 2020;4(3):1.

Al-Jabir A, Kerwan A, Nicola M, Alsafi Z, Khan M, Sohrabi C et al. Impact of the Coronavirus (COVID-19) pandemic on surgical practice-Part 1. Int J Surg. 2020;79:168-79.

Karaca AS, Özmen MM, Uçar AD, Yastı AÇ, Demirer S. COVID-19'lu hastalarda genel cerrahi ameliyathane uygulamaları. Turk J Surg. 2020;36:VI-X.

Zhao S, Ling K, Yan H, Zhong L, Peng X, Yao S et al. Anesthetic management of patients with COVID 19 infections during emergency procedures. J cardiothoracic vascular anesthesia. 2020;34(5):1125-31.

English W, Habib Bedwani N, Smith C, Shatkar V. Investigation and management of suspected appendicitis during the COVID ‐19 pandemic. Br J Surg. 2020;107:e337-8.

Di Saverio S, Sibilio A, Giorgini E, Biscardi A, Villani S, Coccolini F et al. The NOTA Study (Non Operative Treatment for Acute Appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis. Ann Surg. 2014;260(1):109-17.

Hussain A, Manejula O, Ghosh A, Shuaib S, Soliman H, Hafeez R et al. Impact of COVID-19 on Emergency General Surgery. Ann Colorectal Res. 2020;8(3):120-24.

Zhao N, Wu L, Cheng Y, Zheng H, Hu P, Hu C et al. The effect of emergency surgery on acute abdomen patients with COVID-19 pneumonia: a retrospective observational study. Aging (Albany NY). 2020;12(15):15771.

Charalampos S, Archer L, Lalou L. Minimal impact of COVID-19 outbreak on the postoperative morbidity and mortality following emergency general surgery procedures: Results from a 3-month observational period. Depart Gen Surg (UK). 2020;17:275-80.






Original Research Articles