A Peculiar Case of Small Bowel Stricture in a Coronavirus Disease 2019 Patient with Congenital Adhesion Band and Superior Mesenteric Vein Thrombosis
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Background There is increasing evidence supporting coronavirus disease 2019 (COVID-19)-related coagulopathy. In the available literature, only 2 cases of superior mesenteric vein thrombosis have been described.Methods We present a peculiar case of high-grade small bowel obstruction in a patient with COVID-19 infection.Results Exploratory laparotomy revealed a congenital adhesion band with associated focal bowel ischemia contributed by superior mesenteric vein thrombosis and positive lupus anticoagulant.Conclusions It is important to consider the rare differential of mesenteric vein thrombosis and its related sequelae of mesenteric ischemia in a patient with COVID-19 who presents with abdominal pain.
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The association between cardiovascular disease and SMVT is mainly due to effects of cardiovascular diseases such as hypertension, along with viral infection, on the vascular homeostatic system, promoting an inflammatory and turbulent environment that favors a pre-thrombotic process that might lead to PSMVT.
“This association is mainly due to the effects that cardiovascular diseases such as hypertension, along with the viral infection, tend to provoke on the vascular homeostatic system, promoting an inflammatory and turbulent environment that favors the emergence of a pre-thrombotic process that might lead to PSMVT.3”
From Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review (2025) · cites this paper as [3]
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Experimental — accuracy not yet measuredHypercoagulability state might result from deregulated hyperinflammatory response secondary to viral infection and virus spreading through ACE-2, since high levels of Von Willebrand factor have been observed in severe COVID-19 cases.
“Secondly, a hypercoagulability state might result from the deregulated hyperinflammatory response secondary to the viral infection, and the virus spreading through the ACE-2, since high levels of Von Willebrand factor (a protein that enables platelet aggregation on blood vessel lesion sites) have been observed in severe COVID-19 cases.2,3”
From Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review (2025) · cites this paper as [3]
The Discussion (page not provided) says SARS-CoV-2 may injure endothelial cells by binding to ACE2 receptors and that a hypercoagulable state can result from a dysregulated inflammatory response to infection. It does not report elevated von Willebrand factor in severe COVID-19 or describe its role in platelet aggregation. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe coagulation disorder induced by systemic inflammatory condition, endothelial malfunction, and immobilization might predispose to development of PSMVT.
“Thus, the coagulation disorder induced by the systemic inflammatory condition, endothelial malfunction, and immobilization might predispose to development of PSMVT.3,4”
From Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review (2025) · cites this paper as [3]
The Discussion describes COVID-19–related coagulopathy in terms of endothelial injury, a hyperinflammatory response, and blood stasis from immobilization. It also links COVID-19 to the reported superior mesenteric vein thrombosis, but does not specifically address PSMVT as a broader condition. (LLM, conf=0.83)
Experimental — accuracy not yet measuredVascular stasis might be a consequence of immobilization of patients severely affected by the disease.
“Thirdly, vascular stasis might be a consequence of the immobilization of patients severely affected by the disease.”
From Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review (2025) · cites this paper as [3]
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References 14 · Cited by 24
- Authors
- Pang, J. H. Q., Tang, J. H., Eugene-Fan, B., Lee, C. L., & Low, J. K.
- Affiliations
- Tan Tock Seng Hospital (SG)
- Ng Teng Fong General Hospital (SG)
- Corresponding author
- Low, Jee Keem
- Venue
- Annals of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 70
- Pages
- 286-289
- ISSN
- 0890-5096 (ISSN-L)
- PMC
- PMC7453213
- OpenAlex
- W3080550016
- Cited by
- 24
- References
- 14
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 10 · 2020: 2
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Vascular Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Keywords
- COVID-19 pandemic, small bowel strictures, small bowel obstruction, superior mesenteric vein thrombosis, mesenteric ischemia, lupus anticoagulant, abdominal pain
- MeSH terms
- COVID-19, SARS-CoV-2, Tissue Adhesions, Adult, Anticoagulants, Digestive System Abnormalities, Humans, Male, Mesenteric Vascular Occlusion, Mesenteric Veins, Digestive System Surgical Procedures, Biomarkers, Abdominal Pain, Lupus Coagulation Inhibitor, Treatment Outcome, Host-Pathogen Interactions, Mesenteric Ischemia
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