A Woman’s Covid Cough Caused Her Guts to Spill Out

You can now add evisceration to the long list of things that covid-19 can potentially trigger. In a case report, doctors detail how their patient’s covid-induced cough caused her guts to spill out from an old surgical site. The patient was hospitalized, but surgeons were able to put her back together successfully.

This article contains graphic descriptions that some readers might find upsetting. 

Surgeons at the University of Illinois at Chicago wrote about the case, which involved a 52-year old woman. More than a decade earlier, the woman underwent abdominal surgery to treat a hernia. Unfortunately, the hernia continued to cause trouble and she required additional procedures to repair it over the years.

A gut-spilling cough

Five days before she visited the hospital, the woman had come down with covid-19. She experienced repeated episodes of coughing and, after an especially unlucky fit, her bowels burst out of her body through the hernia repair site. By the time she reached the hospital, she was in dire enough straits that she had to be resuscitated. But surgeons were able to carefully push her guts back in where they belonged and close her wound up without major complications. 

Abdominal wounds from a surgery can occasionally reopen. Losing your guts through a reopened wound—a literal evisceration, or disembowelment—is very rarely reported, however. Coughing is often associated with these cases, since a strong enough cough can abruptly raise air pressure within the abdomen. The woman’s lengthy surgical history also made her more susceptible to such an injury than most. That said, this still seems to be a freak occurrence. 

A covid rarity

“To our knowledge, this is the first case of evisceration due to covid-19 infection exacerbation,” the doctors wrote in their case report, which was first published in the Journal of Gastrointestinal Surgery in March 2022. A version of the paper appears to have only been made available online in January 2024. 

The woman did need several layers of stitches to ensure that her guts would stay put. But she was able to start eating food again within two days of her surgery, and she was released from the hospital six days post-operation in good condition. The doctors do provide some images of the grisly injury and their successful repair after, but I wouldn’t recommend viewing them if you don’t have a (metaphorically) strong stomach.  

As rare as these incidents are, this is remarkably the second similar case this month to receive media attention. In May, doctors wrote about a 63-year-old man who sneezed and coughed out his guts through a recent surgical site, just after a medical check-up seemed to confirm that his wounds had healed completely. The man’s diner breakfast and shirt were ruined, but he too made a complete recovery. 

Obviously, the lesson to be learned here from these incredibly unusual injuries is: never cough.