Superior Mesenteric Artery Thrombosis in COVID-19 Pneumonia: An Underestimated Diagnosis—First Case Report in Asia
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Abstract
The COVID-19 disease caused by novel coronavirus was first reported in Wuhan, China, in December 2019 with 5% patients having severe lung injury. Though this disease primarily presents as a lower respiratory tract infection, multiple digestive manifestations have been reported which are often overlooked. The present case report describes the unusual progression of COVID-19 disease from pneumonia to a procoagulant state leading to superior mesenteric artery thrombosis and subsequent gut ischemia necessitating emergency laparotomy. Coagulopathy in COVID-19 is due to an imbalance in the coagulation homeostasis with increase in prothrombin time, fibrinogen, and D-dimers. Early recognition of abdominal symptoms, diagnosis of pathology, and timely surgical intervention may definitely improve outcome. In the management of any patient with COVID-19 disease, we advocate a comprehensive integrated approach with early recognition of digestive symptoms and their timely intervention which should run parallel to the respiratory management.
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30 case reports or case series presented 34 cases of acute bowel ischemia in patients positive for SARS-CoV-2 infection in different clinical settings.
“We also identified 30 case reports or case series [22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51] presenting 34 cases of acute bowel ischemia in patients positive for SARS-CoV-2 infection in different clinical settings.”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [25]
Heparin has an anticoagulant, anti-inflammatory, endothelial protective role in COVID-19, which can improve microcirculation and decrease possible ischemic events.
“Heparin has an anticoagulant, anti-inflammatory, endothelial protective role in COVID-19, which can improve microcirculation and decrease possible ischemic events [25].”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [25]
Mucosal ischemia may induce massive viremia from bowel epithelium causing vasoplegic shock after surgery.
“Mucosal ischemia may induce massive viremia from bowel epithelium causing vasoplegic shock after surgery [25].”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [25]
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- Authors
- Karna, S. T., Panda, R., Maurya, A. P., & Kumari, S.
- Affiliations
- All India Institute of Medical Sciences Bhopal (IN)
- Corresponding author
- Karna, Sunaina Tejpal
- Venue
- Indian Journal of Surgery
- Published
- 2020-10-19
- Volume
- 82
- Issue
- 6
- Pages
- 1235-1237
- ISSN
- 0972-2068 (ISSN-L)
- 0973-9793
- PMC
- PMC7571302
- OpenAlex
- W3092962942
- Cited by
- 32
- References
- 9
- Citations by year
- 2024: 4 · 2023: 3 · 2022: 10 · 2021: 14 · 2020: 1
- FWCI
- 6.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Indian Journal of Surgery (publishedVersion)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Ophthalmology › Retinal and Optic Conditions
- Keywords
- COVID-19 pandemic, superior mesenteric artery thrombosis, COVID-19 pneumonia, gut ischemia, procoagulant state, coagulopathy, D-dimer, emergency laparotomy, abdominal symptoms
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