Although COVID-19 typically presents with respiratory symptoms including fever, cough, and shortness of breath, many patients may be asymptomatic, particularly initially in the course of infection. Patients with COVID-19 may also present with non-specific gastrointestinal signs and symptoms, most commonly abdominal pain, which may be referred pain from lung base infection, and/or may be due to abdominal manifestations of the virus. Lung base CT findings of COVID-19 infection in patients without respiratory symptoms are frequently ground-glass opacities in a peripheral or peribronchovascular distribution. We have also seen other findings within the abdomen and pelvis on CT which may be related directly to COVID-19 infection, such as hepatitis or pancreatitis. Patients initially presenting with primarily gastrointestinal complaints may ultimately develop respiratory symptoms. The purpose of this exhibit is to review the unexpected findings of COVID-19 at the lung bases on abdominal CT and also to show a spectrum of findings on abdominopelvic CT which appear to be related to COVID-19.
Educational Goals / Teaching Points
Unexpected lung base findings concerning for COVID-19 in patients previously not expected to have COVID-19 infection, as identified on abdominal CT
-Typically ground-glass opacities, peripheral or peribronchovascular
-No other findings to explain the patients’ pain, or concurrent findings of mild luminal tract involvement
Abdominopelvic CT findings in patients with COVID-19
-Urinary calculi, specifically uric acid
Outcomes of patients presenting with abdominal symptoms
-Later development of respiratory symptoms
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Unexpected lung base findings concerning for COVID-19 are typically ground-glass opacities, peripheral or peribronchovascular.
Abdominopelvic CT findings in patients with COVID-19 include urinary calculi, pancreatitis, hepatitis, splenomegaly, and pyelonephritis.
Unsuspected COVID-19 infection may be strongly suggested based on abdominal CT lung findings, in patients presenting with abdominal signs and symptoms. Patients with COVID-19 may also develop abdominopelvic manifestations of viral infection.