case_images: PMC7467885_01
case_images: computed tomography of kidneys, ureters, and bladder revealed an obstructive left ureteric calculus at the vesicoureteric junction (VUJ) measuring 4.7 mm with no obvious fat stranding
case_images: PAMJ-36-170-g001.jpg
case_images: PMC7467885_01_PAMJ-36-170-g001.jpg
case_images: F1
case_images: Computed tomography of the kidneys, ureters, and bladder revealed an obstructive left ureteric calculus at the vesicoureteric junction (VUJ) measuring 4.7mm (Figure 1).
case_images: ECG showing normal sinus rhythm with sinus tachycardia
case_images: PAMJ-36-170-g002.jpg
case_images: PMC7467885_01_PAMJ-36-170-g002.jpg
case_images: F2
case_images: The pre-operative assessment involved medication review and ECG, which was considered normal (Figure 2). He was then transferred to the ward for post-operative management and close observation. 12 hours post-transfer to the ward he was found to be tachycardic at 130 beats per minute with normal sinus rhythm (Figure 2) and blood pressure ranging from 80/50 mmHg to 90/60 mmHg.
case_images: ECG showing nonspecific ST changes and T wave inversion with no ST elevation
case_images: PAMJ-36-170-g003.jpg
case_images: PMC7467885_01_PAMJ-36-170-g003.jpg
case_images: F3
case_images: On workup, it was found that the patient had an abnormal ECG with ST-segment depressions and T wave inversion on the anterior (V1- V4) and inferior leads (III & aVF) (Figure 3), when compared to the preoperative ECG with markedly elevated troponin-T of 174.1 pg/ml (0-14 pg/ml).
case_images: X-ray Chest showing bilateral patchy infiltrates, cardiomegaly, and unfolded aorta are seen
case_images: PAMJ-36-170-g004.jpg
case_images: PMC7467885_01_PAMJ-36-170-g004.jpg
case_images: F4
case_images: A portable chest x-ray revealed bilateral patchy pulmonary infiltrates with some coalescence observed in the periphery of lungs, a pattern consistent with a CO-RADS 5 classification, highly suggestive of COVID-19 (Figure 4), and was later confirmed by a nasopharyngeal swab using real-time reverse transcription-polymerase chain reaction (RT-PCR).