BACKGROUND:

Pregnant women infected with SARS-CoV-2 were 2.9 times more likely to require invasive ventilation. Acute cholecystitis is the second most common surgical indication in pregnancy. In the literature search, no reports of concomitance of both diseases during pregnancy were found, for this reason the clinical case report is published and the literature is reviewed.

CASE REPORT:

32-year-old female patient, in the course of 23 weeks of pregnancy. Due to symptoms of COVID-19, with positive PCR test, she was hospitalized for initiation of invasive mechanical ventilation. On the ninth day of hospitalization, she had elevated transaminases and CT report of acute cholecystitis alliasis. Percutaneous cholecystostomy was indicated, which relieved the hepatobiliary symptoms. In the second surgical stage, a cesarean section was performed. Three days later she experienced gradual ventilatory and biochemical improvement. After 32 days of hospitalization, intubation was achieved and, after 54 days, she was discharged from the hospital, without requiring supplemental oxygen.

CONCLUSIONS:

Finding, in conjunction with severe COVID-19 acute respiratory failure syndrome requiring invasive mechanical ventilation, pre-viable pregnancy, alliasic cholecystitis, places the pregnant woman and the medical team in serious medical, surgical, and bioethical dilemmas. Percutaneous cholecystostomy in patients with hemodynamic instability and termination of pregnancy in case of ventilatory deterioration in the face of acute respiratory failure syndrome is a controversial option. Evidence-based procedures and multidisciplinary sessions, including the family, are undoubtedly conducive.

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