Korean J Gastroenterol.  2020 Sep;76(3):164-166. 10.4166/kjg.2020.76.3.164.

Acute Intestinal Ischemia in a Patient with COVID-19 Infection

Affiliations
  • 1Departments of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, USA
  • 2Departments of Internal Medicine, Saint Joseph's University Medical Center, Paterson, USA
  • 3Departments of Cardiology, Saint Joseph's University Medical Center, Paterson, USA

Abstract

The World Health Organization has declared novel coronavirus disease 2019 (COVID-19) a global public health emergency. Although respiratory symptoms predominate in COVID-19, thrombosis can occur in patients with COVID-19. This paper reports a case of an 82-year-old female with a prior medical history of hypertension, diabetes presenting with fever and cough, and was diagnosed with COVID-19. The patient subsequently developed progressively worsening of abdominal distention, tenderness, and underwent emergent laparotomy. She was found to have a gangrenous colon. This case adds to the limited literature regarding the extrapulmonary complications of COVID-19.

Keyword

COVID-19; Arterial thrombosis; Severe acute respiratory syndrome coronavirus 2; Mesenteric ischemia; Ischemic colitis

Figure

  • Fig. 1 Computed tomography of the abdomen showing moderate distention of the colon with significant pneumatosis intestinalis (presence of gas within the wall of the intestine-arrow) involving the ascending colon and the cecum.

  • Fig. 2 Pathological findings (H&E, ×20): colon segment showing extensive mucosal, submucosal necrosis (upper arrow), and microthrombi (lower arrow).


Reference

1. Guan WJ, Ni ZY, Hu Y, et al. 2020; Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 382:1708–1720. DOI: 10.1056/NEJMoa2002032. PMID: 32109013. PMCID: PMC7092819.
2. Kaur P, Qaqa F, Ramahi A, et al. 2020; May. 13. Acute upper limb ischemia in a patient with COVID-19. Hematol Oncol Stem Cell Ther. [Epub ahead of print]. DOI: 10.1016/j.hemonc.2020.05.001. PMID: 32405288. PMCID: PMC7219365.
Article
3. Kaur P, Posimreddy S, Singh B, et al. 2020; May. 19. COVID-19 presenting as acute limb ischaemia. Eur J Case Rep Intern Med. [Epub ahead of print]. DOI: 10.1111/jocs.14999. PMID: 32939794.
Article
4. Varga Z, Flammer AJ, Steiger P, et al. 2020; Endothelial cell infection and endotheliitis in COVID-19. Lancet. 395:1417–1418. DOI: 10.1016/S0140-6736(20)30937-5. PMID: 32955690.
Article
5. Panigada M, Bottino N, Tagliabue P, et al. 2020; Hypercoagulability of COVID-19 patients in intensive care unit: a report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 18:1738–1742. DOI: 10.1111/jth.14850. PMID: 32302438.
Article
6. Parry AH, Wani AH, Yaseen M. 2020; Acute mesenteric ischemia in severe coronavirus-19 (COVID-19): possible mechanisms and diagnostic pathway. Acad Radiol. 27:1190. DOI: 10.1016/j.acra.2020.05.016. PMID: 32475635. PMCID: PMC7245306.
Article
7. Bianco F, Ranieri AJ, Paterniti G, Pata F, Gallo G. 2020; Jun. 6. Acute intestinal ischemia in a patient with COVID-19. Tech Coloproctol. [Epub ahead of print]. DOI: 10.1007/s10151-020-02255-0. PMID: 32506344. PMCID: PMC7275842.
Article
8. Bala M, Kashuk J, Moore EE, et al. 2017; Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 12:38. DOI: 10.1186/s13017-017-0150-5. PMID: 28794797. PMCID: PMC5545843.
Article
Full Text Links
  • KJG
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr