Purpose
The COVID-19 pandemic significantly disrupted surgical services and necessitated the development of new clinical protocols. National Health Insurance Service Ilsan Hospital in Korea established a COVID-19 Emergency Surgical Team (CEST) to manage surgical cases and optimize medical staff utilization, thereby ensuring timely care during the pandemic. This study describes our experience with the CEST and highlights its potential role in institutional preparedness for future public health crises.
Methods
Between December 19, 2020, and April 4, 2022, this study included patients with laboratory-confirmed COVID-19 who were hospitalized at National Health Insurance Service Ilsan Hospital, a designated COVID-19 treatment center in Korea. Among these patients, those who underwent abdominopelvic computed tomography (APCT) were selected for analysis, and the indications for APCT were categorized. Patients specifically evaluated for suspected surgical abdomen were identified for subgroup analysis.
Results
Among 90 patients who underwent APCT, 32 (36.0%) were evaluated for suspected acute abdomen requiring urgent attention; 25 (28.1%) for persistent fever or elevated inflammatory markers; 15 (16.9%) for acute kidney injury; and 7 (7.9%) for liver enzyme elevation. Compared with the remaining 3,765 patients, the 32 patients with suspected surgical abdomen were significantly older and had longer hospital stays, higher rates of intensive care unit admission, and greater use of high-flow nasal cannula, dexamethasone, and antibiotics. Initial laboratory findings demonstrated higher white blood cell count, ferritin, creatinine, bilirubin, and D-dimer levels in this group. This case series underscores the role of the CEST in managing surgical patients with COVID-19.
Conclusion
We describe our institutional experience with the CEST and emphasize how the lessons learned may inform preparedness for future public health emergencies. This model may serve as a practical framework for managing surgical care during similar crises.

Tuberculosis is known as “the great mimicker.” Extrapulmonary tuberculosis accounts for approximately 20% of all cases, with about 10% of these involving the intestines. The ileocecal region is the most common site due to its high density of lymphoid tissue, slowed intestinal transit, and low bile acid concentration. We report the case of a 16-year-old male student who presented with symptoms consistent with an acute abdomen and required emergency laparotomy; subsequent histological examination confirmed tuberculosis. Diagnosis is challenging because of nonspecific symptoms that mimic other common conditions such as appendicitis. Imaging studies lack specificity, while positive Ziehl-Neelsen staining and the presence of Langerhans-type giant cell granulomas on histologic analysis are among the most sensitive and rapid diagnostic indicators. Intestinal tuberculosis carries a poor prognosis, particularly when associated with complications such as obstruction, perforation, or intestinal stenosis. Medical management follows the same antibiotic regimen used for pulmonary tuberculosis, whereas surgical intervention is reserved for acute abdominal complications.

Citations

• A Case Study of Acute Appendicitis Improved by Pharmacopuncture Treatment
  Soo-ho Cho, Chul Jung, Keum-ji Kim, Seok-jae Ko, Hwan-su Jung, Jae-woo Park
  The Journal of Internal Korean Medicine.2019; 40(2): 208.     CrossRef