Acute mesenteric ischemia in a COVID-19 patient from Nepal: A case report and review of literature. (October 2022)

• Record Type: Journal Article
• Authors: Basukala, Sunil; Tamang, Ayush; Bhusal, Ujwal; Sharma, Shriya; Gurung, Samundra
• Is Part Of: International journal of surgery case reports. Volume 99(2022)
• Publication Date: 2022-10
• Subjects: COVID-19 -- SARS-CoV-2 -- Acute mesenteric ischemia -- Hypercoagulability -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107703
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: The incidence of acute mesenteric ischemia (AMI) among critically ill COVID-19 patients has been reported ranging from 3.8 to 4 %. Presentation of case: A 57-year-old female presented with acute abdomen for last three days and tested positive for COVID-19. Abdominal X-ray showed prominent dilated small bowel loops with multiple air fluid levels, and absence of a completely visible colon. She underwent emergency laparotomy where blackish gangrenous bowel loops were seen and resected. Discussion: CECT scan in over half of the AMI patients may show patent mesenteric vessels. However, such patency of mesenteric vessels should not rule out the possibility of AMI in cases of COVID-19 with prominent GI signs and symptoms, especially those admitted in ICU. Conclusion: AMI is a life-threatening complication that may occur in COVID-19 patients. It should be suspected in COVID-19 patients complaining of severe abdominal pain in addition to pulmonary symptoms. Highlights: The incidence of Acute Mesenteric Ischemia (AMI) among critically ill COVID-19 patients has been reported ranging from 3.8 to 4%. COVID-19 is known to induce a hypercoagulable state leading to both micro- and macrovascular thrombosis. CECT scan in over half of the AMI patients may show patent mesenteric vessels. It should be suspected in COVID-19 patients complaining of severe abdominal pain in addition to pulmonary symptoms.