Coexisting portal vein thrombosis and aortic thrombosis in a patient with COVID-19: A case report and literature review

Akella, Ramya; Raj, Rishi; Kannan, Lakshmi; Jacob, Aasems

doi:10.1016/j.idcr.2022.e01509

Cited by 2 publications

(2 citation statements)

References 22 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, imaging with CT scan, ultrasound, or MRI will facilitate the diagnosis[ 25 , 26 ]. Once the diagnosis is made, treatment with anticoagulation must be prioritized, as early anticoagulation has been associated with positive outcomes[ 27 , 28 ]. Low molecular weight heparin (LMWH) is often utilized as the primary anticoagulant of choice in COVID-19 patients rather than direct oral anticoagulants, as LMWH is less likely to have negative drug interactions with antiviral therapies[ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient: A case report and review of literature

Abramowitz,

Coles,

Aytaman

et al. 2024

World J Clin Cases

View full text Add to dashboard Cite

BACKGROUND It is well-described that the coronavirus disease 2019 (COVID-19) infection is associated with an increased risk of thrombotic complications. While there have been many cases of pulmonary emboli and deep vein thrombosis in these patients, reports of COVID-19 associated portal vein thrombosis (PVT) have been uncommon. We present a unique case of concomitant PVT and splenic artery thrombosis in a COVID-19 patient. CASE SUMMARY A 77-year-old-male with no history of liver disease presented with three days of left-sided abdominal pain. One week earlier, the patient was diagnosed with mildly symptomatic COVID-19 and was treated with nirmatrelvir/ritonavir. Physical exam revealed mild right and left lower quadrant tenderness, but was otherwise unremarkable. Significant laboratory findings included white blood cell count 12.5 K/μL, total bilirubin 1.6 mg/dL, aminoaspartate transferase 40 U/L, and alanine aminotransferase 61 U/L. Computed tomography of the abdomen and pelvis revealed acute PVT with thrombus extending from the distal portion of the main portal vein into the right and left branches. Also noted was a thrombus within the distal portion of the splenic artery with resulting splenic infarct. Hypercoagulable workup including prothrombin gene analysis, factor V Leiden, cardiolipin antibody, and JAK2 mutation were all negative. Anticoagulation with enoxaparin was initiated, and the patient’s pain improved. He was discharged on apixaban. CONCLUSION It is quite uncommon for PVT to present simultaneously with an arterial thrombotic occlusion, as in the case of our patient. Unusual thrombotic manifestations are classically linked to hypercoagulable states including malignancy and hereditary and autoimmune disorders. Viral infections such as Epstein-Barr virus, cytomegalovirus, viral hepatitis, and COVID-19 have all been found to increase the risk of splanchnic venous occlusions, including PVT. In our patient, prompt abdominal imaging led to early detection of thrombus, early treatment, and an excellent outcome. This case is unique in that it is the second known case within the literature of simultaneous PVT and splenic artery thrombosis in a COVID-19 patient.

show abstract

Section: Discussionmentioning

confidence: 99%

Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient: A case report and review of literature

Abramowitz,

Coles,

Aytaman

et al. 2024

World J Clin Cases

View full text Add to dashboard Cite

show abstract

“…For non-critically ill patients hospitalized with COVID-19, a high index of suspicion is necessary for detecting thromboembolism, especially when the patient presents with acute abdominal pain, chest pain, or lower extremity pain [17,18]. Therapeutic-dose heparin appears beneficial, with a high probability of reducing the need for organ support and the progression to intubation and death, regardless of D-dimer results [19].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and Cavitary Lesion in Lung

Vangara¹,

Rahmlow²,

Gullapalli³

et al. 2023

Cureus

View full text Add to dashboard Cite

The clinical manifestations of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widespread, ranging from asymptomatic to critical illness with significant morbidity and mortality. It is widely known that individuals who have viral respiratory infections are more likely to develop bacterial infections. Throughout the pandemic, despite the fact that COVID-19 was thought to be the primary cause of millions of deaths, bacterial coinfections, superinfections, and other secondary complications played a significant role in the increased mortality rate. In our case, a 76-year-old male presented to the hospital complaining of shortness of air. Polymerase chain reaction (PCR) testing was positive for COVID-19 and cavitary lesions were discovered on imaging. Treatment was guided based on the results of bronchoscopy with bronchoalveolar lavage (BAL) cultures showing methicillin-resistant Staphylococcus aureus (MRSA) and Mycobacterium gordonae. However, the case was later complicated by the development of a pulmonary embolism after anticoagulants were held due to new onset hemoptysis. Our case highlights the importance of considering bacterial coinfection in cavitary lung lesions, appropriate antimicrobial stewardship, and close follow-up for full recovery in COVID-19 infections.

show abstract

Coexisting portal vein thrombosis and aortic thrombosis in a patient with COVID-19: A case report and literature review

Cited by 2 publications

References 22 publications

Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient: A case report and review of literature

Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient: A case report and review of literature

COVID-19 and Cavitary Lesion in Lung

Contact Info

Product

Resources

About