Unusual presentation of coronavirus disease 2019 (COVID-19): two cases of acute abdomen

December 2019 SARS-CoV-2 is responsible for the novel coronavirus-infected pneumonia associated with acute respiratory distress syndrome, organ dysfunction and death. Since its discovery, a myriad of clinical presentations have surfaced and the past year has been a learning experience for all. We present two cases of acute abdomen presenting as a “surgical abdomen”; one had a negative laparotomy and negative PCR test, and the other who did not have surgery eventually tested positive on PCR testing. Both were incidentally diagnosed with COVID-19 pneumonia on a chest computed tomography scan and managed accordingly. It is unclear whether reported gastrointestinal manifestations are a direct causal effect of the virus in the gastrointestinal tract. Surgeons should be aware that COVID-19 can present as a “surgical abdomen” which may lead to negative laparotomies.