Superior Mesenteric Artery Thrombosis and Acute Intestinal Ischemia as a Consequence of COVID-19 Infection
Open accessAbstract
BACKGROUND The novel COVID-19 disease caused by the SARS-CoV-2 virus is a highly infectious disease that originated in Wuhan, China, and has rapidly spread throughout the world. In addition to respiratory complications, the virus has also been implicated in damage to other organ systems as well as coagulopathy. The present report describes the first presumptive case of COVID-19-associated acute superior mesenteric artery thrombosis and acute intestinal ischemia. CASE REPORT A 55-year old man presented to the emergency department with nausea, generalized abdominal pain and diarrhea; he denied having a fever or any respiratory symptoms. Computed tomography (CT) of the abdomen and pelvis revealed bilateral pulmonary ground-glass opacities. He tested positive for SARS-CoV-2, and was treated with hydroxychloroquine, azithromycin and ceftriaxone, and was discharged home after five days of inpatient treatment. One week later, the patient returned with recurrent nausea, vomiting and worsening diffuse abdominal pain. A CT scan of the abdomen showed a 1.6-cm clot, causing high grade narrowing of the proximal superior mesenteric artery and bowel ischemia. The patient emergently underwent exploratory laparotomy, thromboembolectomy and resection of the ischemic small bowel. A post-operative complete hypercoagulable workup was unrevealing. CONCLUSIONS Despite the absence of respiratory symptoms, patients infected with SARS-CoV-2 may show atypical presentations, such as gastrointestinal symptoms. Clinicians managing patients with suspected or confirmed SARS-CoV-2 infection during the COVID-19 pandemic should monitor these patients for potential complications that may arise from this disease.
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Guarding may be evocative for peritonitis due to compromised vascularization of bowel loops and bacterial translocation or franc perforation.
“Guarding may be evocative for peritonitis due to compromised vascularization of bowel loops and bacterial translocation or franc perforation [35,39].”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [35]
Thrombocytosis and thrombocytopenia have been reported in published cases with mesenteric ischemia.
“Thrombocytosis and thrombocytopenia have been reported in published cases with mesenteric ischemia [30,35,42,46,50].”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [35]
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COVID-19 ENFEKSİYONUNDA ABDOMİNAL RADYOLOJİK GÖRÜNTÜLEME
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Acute Mesenteric Ischemia during the COVID-19 Pandemic – An Observational Study
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- Authors
- Cheung, S., Quiwa, J. C., Pillai, A., Onwu, C., Tharayil, Z. J., & Gupta, R.
- Affiliations
- Long Island Community Hospital (US)
- Corresponding author
- Cheung, Szeya
- Venue
- American Journal of Case Reports
- Published
- 2020-07-20
- Volume
- 21
- Pages
- e925753-e925753
- ISSN
- 1941-5923 (ISSN-L)
- PMC
- PMC7417027
- OpenAlex
- W3044946574
- Cited by
- 90
- References
- 15
- Citations by year
- 2025: 3 · 2024: 7 · 2023: 13 · 2022: 22 · 2021: 39 · 2020: 6
- FWCI
- 18.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- American Journal of Case Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- 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, SARS-CoV-2, superior mesenteric artery thrombosis, acute mesenteric ischemia, intestinal ischemia, atypical presentation, gastrointestinal symptoms, thromboembolism, thromboembolectomy, coagulopathy
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Diarrhea, Humans, Infarction, Intestines, Ischemia, Male, Mesenteric Vascular Occlusion, Middle Aged, Pneumonia, Viral, Thrombosis, Tomography, X-Ray Computed, Abdominal Pain, Embolectomy, Thrombectomy, Mesenteric Artery, Superior, Coronavirus Infections, Pandemics
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