PMC7467885_01
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
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F1
Computed tomography of the kidneys, ureters, and bladder revealed an obstructive left ureteric calculus at the vesicoureteric junction (VUJ) measuring 4.7mm (Figure 1).
ECG showing normal sinus rhythm with sinus tachycardia
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F2
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.
ECG showing nonspecific ST changes and T wave inversion with no ST elevation
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F3
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).
X-ray Chest showing bilateral patchy infiltrates, cardiomegaly, and unfolded aorta are seen
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F4
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).