The Background Behind the Safe Surgery of a Suspected COVID-19 Emergency Patient...

Hallym University Dongtan Sacred Heart Hospital Performs Emergency Surgery for Peritonitis in Overseas Quarantine Patient
Negative Pressure Room and Level D Protective Suit Used Before COVID-19 Test Results

[Asia Economy Reporter Choi Dae-yeol] It was later revealed that a patient with peritonitis, who was under self-quarantine after returning from overseas, safely underwent emergency surgery. Although there were concerns about the novel coronavirus infection (COVID-19), the medical staff proceeded with the surgery despite the risk of infection before the diagnostic test results were available, as the situation was urgent.

According to Hallym University Dongtan Sacred Heart Hospital on the 6th, a woman in her 50s who returned from the United States in April underwent emergency surgery for peritonitis. The patient, who returned three days before visiting the hospital, had undergone colorectal cancer surgery in the U.S. and was suspected of metastasis to the pelvis. However, due to the spread of COVID-19 there, she was told that treatment would be difficult for over three months and decided to return to Korea. Even after returning to Korea, overseas arrivals were required to self-quarantine for two weeks, but her condition worsened, prompting her to visit the hospital.

According to the hospital, when she arrived at the emergency room, a perforation had occurred at the site of the colorectal cancer surgery, causing waste material from the colon to leak out. The hospital stated that the perforation had already begun while she was on the flight back, putting her life in danger. Professor Kim Jeong-yeon, a colorectal specialist and the on-duty surgeon at the time, judged the patient’s condition as severe and decided to perform emergency surgery. The patient tested negative in her first COVID-19 diagnostic test immediately after arrival. However, since some patients have occasionally tested positive later due to the incubation period, the infection status could not be guaranteed.

Immediately upon arrival at the emergency room, a COVID-19 test was conducted, but the medical staff could not wait for the results and prepared for infection prevention, proceeding with surgery at 2 a.m. the next day. This was about seven hours after the patient arrived at the emergency room. To prevent infection in the operating room, intubation was performed separately in a negative pressure isolation room in the intensive care unit, and the patient was transported to the operating room using a negative pressure transport cart. All medical staff participating in the surgery wore Level D protective suits over their surgical gowns.

To minimize the surgery time, Professor Kim performed a colostomy. After removing the leaked waste and washing the remaining area, a stoma was created to prevent further leakage, completing the surgery in the shortest possible time. The surgery lasted three hours, but the medical staff in Level D protective suits remained tense throughout. After the surgery, the operating room was partially closed for three days and fully disinfected.

Fortunately, the surgery outcome was good. The second test also came back negative. Although there was concern about sepsis, the patient overcame it well and was able to resume daily activities within a week. After receiving treatment in an isolation ward for two weeks, she tested negative again before discharge and was safely released. Professor Kim said, "If left untreated, peritonitis has a mortality rate of 48%, and the mortality rate increases by 5-8% each day, so following the principle of prioritizing treatment for severe cases, we decided to treat the peritonitis patient despite the risk of infection. It was more challenging than performing surgery on 10 colorectal cancer patients, but I felt rewarded seeing the patient recover healthily."

As the COVID-19 situation prolonged and concerns about in-hospital infections increased, patients with suspected symptoms such as fever were increasingly avoided even within hospitals. An analysis by the Korean Society of Emergency Medicine of patients visiting 10 emergency rooms, including regional emergency medical centers and severe emergency medical centers in Gyeonggi Province, showed that although the number of patients visiting emergency rooms in February and March this year decreased by more than half, the number of patients who died in the emergency room or were transported dead increased. A patient from Seosan, Chungnam, about 150 km away, was unable to find a nearby hospital and had to visit Hallym University Dongtan Sacred Heart Hospital.

Currently, COVID-19 diagnostic tests take at least six hours from specimen collection to result. Since emergency room patients often require urgent care, if there are suspected symptoms, surgery must be performed following infection control guidelines equivalent to those for COVID-19 patients. Shin Dong-woo, head of surgery at Hallym University Dongtan Sacred Heart Hospital, said, "Medical staff performing surgery on suspected COVID-19 patients with high fever operate under conditions several times more difficult than usual surgeries, prepared even for isolation."

This content was produced with the assistance of AI translation services.