Late mesenteric ischemia after Sars-Cov-2 infection: case report

Abstract

The purpose of this article is to report the case of a 53-year-old black man, with no previous comorbidities, who presented 48 days after a confirmed diagnosis of COVID-19, complaining of an initially insidious epigastric pain that had progressed to severe pain radiating to the interscapular vertebral region, with hyporexia and episodes of projectile vomiting, with no nausea or fever. Laboratory tests revealed no signs of acute infection or pancreatic injury. Abdominal computed tomography showed dilated, fluid-filled small bowel loops with thickened walls. After clinical treatment, the patient developed persistent abdominal pain. An exploratory laparotomy was performed, finding two sites of small bowel stenosis, with no extrinsic cause, and signs of local ischemia and considerable distension of jejunal and ileal loops. After enterectomy and side-to-side enteroanastomosis, the patient recovered satisfactorily and was discharged with a prescription for oral anticoagulants for outpatient use.

Diagnóstico e manejo de isquemia aguda de membro em paciente pós infecção viral por covid-19: série de casos

“… 13 Pulmonary embolism was the most common thrombotic event among these patients, despite administration of thromboprophylaxis in hospital in some cases. 14 Reports have been published describing different clinical presentations and management of these events, such as ischemic stroke, 15 deep venous thrombosis (DVT), mesenteric ischemia, 16 thrombosis of the abdominal aorta and common iliac artery bilaterally, 17 arterial thrombosis limbs in isolation, 18 , 19 and even association with autoimmune diseases. 20 Teng et al 21 described the case of a patient who had two episodes of acute arterial occlusion of the right lower limb during the infection and even using anticoagulant therapy (due to the patient having developed pulmonary embolism).…”

“…A embolia pulmonar foi identificada como o evento trombótico mais comum nesses pacientes, apesar da aplicação de tromboprofilaxia durante o internamento em alguns casos 14 . Já foram publicados relatos de diferentes apresentações clínicas e condutas frente a esses eventos, como acidente vascular encefálico isquêmico (AVEi) 15 , trombose venosa profunda (TVP), isquemia mesentérica 16 , trombose de aorta abdominal e de artéria ilíaca comum bilateralmente 17 , trombose arterial de membros isoladamente 18 , 19 e até mesmo associação com doenças autoimunes 20 . Teng et al 21 descreveram o caso de um paciente que, durante a infecção e mesmo em uso de terapia anticoagulante (pois o paciente havia desenvolvido embolia pulmonar), apresentou dois episódios de oclusão arterial aguda em membro inferior direito 21 .…”

Bowel ischemia as onset of COVID‐19 in otherwise asymptomatic patients with persistently negative swab

“…2) were closely similar to those described in the lungs of COVID‐19 patients [4], supporting the correlation between SARS‐CoV‐2 infection and gastrointestinal symptoms. To our knowledge, this acute and severe intestinal onset has never been reported, even if intestinal infarction was reported as a complication of interstitial pneumonia in patients testing positive for SARS‐CoV‐2 [19–25] and in patients with COVID‐19‐like pneumonia, but a SARS‐CoV‐2 negative swab [26].…”

Perfil de morbimortalidade de pacientes infectados pela COVID-19, evoluções e suas complicações: uma revisão integrativa

“…No Brasil, 58,3% dos óbitos e 53,3% das hospitalizações são de homens. Como também, a taxa de óbitos aos 60 anos já alcança mais de 71,4% e as hospitalizações por SRAG representam 39,2% (Macedo et al, 2021).…”