Mesenteric ischemia in patients with COVID-19: an updated systematic review of abdominal CT findings in 75 patients

Ojha, Vineeta; Mani, Avinash; Mukherjee, A; Kumar, Sanjeev; Jagia, Priya

doi:10.1007/s00261-021-03337-9

Cited by 17 publications

(22 citation statements)

References 55 publications

(32 reference statements)

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“…CM&R 2022 : 4 (December) Sureshkumar and Surendran D-dimer levels and imaging studies, specifically CT angiogram of the abdomen and pelvis has a pivotal role in diagnosing mesenteric ischemia. 7 In our patient, the new symptom onset of abdominal pain was accompanied by a seven-fold increase of D-dimer and around 8-fold increase of CRP. Even thickening, edema, and bowel dilatation >15 mm should raise suspicion for mesenteric ischemia.…”

Section: Discussionsupporting

confidence: 46%

Acute Mesenteric Ischemia in COVID-19 While Receiving Prophylactic Enoxaparin

Sureshkumar¹,

Surendran²

2022

Clin Med Res

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C OVID-19, also called acute respiratory syndrome coronavirus 2 SARS-CoV-2, was declared a pandemic in March 2020. 1 COVID-19, though initially considered as a respiratory tract pathogen, can cause multiple organ dysfunction. 2 Thromboembolic complications are being increasingly reported in COVID-19 pneumonia. 3 The most known complications are deep vein thrombosis, pulmonary embolism, stroke, acute limb ischemia, and acute coronary syndrome. There have also been a few reports of acute mesenteric ischemia in patients with severe COVID-19 pneumonia. 4 Here, we present a case of acute mesenteric ischemia in a COVID patient with a deadly outcome. Case PresentationA Caucasian woman, aged 71 years, unvaccinated against COVID-19, with a pertinent history of hypertension, hyperlipidemia, Class I obesity with a body mass index of 236

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Section: Discussionsupporting

confidence: 46%

Acute Mesenteric Ischemia in COVID-19 While Receiving Prophylactic Enoxaparin

Sureshkumar¹,

Surendran²

2022

Clin Med Res

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“…Endothelial cell damage and thromboinflammation have been suggested as important pathophysiological mechanisms of AMI in COVID-19 [47]. Two recent systematic reviews, largely based on case reports, addressed AMI in patients with COVID [48,49]. Large bowel ischemia occurred in 37% of COVID patients with AMI, and NOMI was considered the main mechanism (68%) [49].…”

Section: Nonocclusive Mesenteric Ischemiamentioning

confidence: 99%

“…Two recent systematic reviews, largely based on case reports, addressed AMI in patients with COVID [48,49]. Large bowel ischemia occurred in 37% of COVID patients with AMI, and NOMI was considered the main mechanism (68%) [49]. In intensive care unit (ICU) patients with COVID and AMI, the large bowel was affected alone in 56% and in association with the small bowel in 24% [48].…”

Section: Nonocclusive Mesenteric Ischemiamentioning

confidence: 99%

Acute mesenteric ischaemia

Blaser

Forbes

Björck

2022

Current Opinion in Critical Care

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Purpose of reviewTo summarize the recent evidence on acute mesenteric ischaemia (AMI).Recent findingsThe overall incidence of AMI is below 10/100 000 person years but increases exponentially with age. The overall mortality of AMI remains high, exceeding 50%, despite continuing progress and increasing availability of imaging and endovascular interventions. However, patients with (early) revascularization have significantly better outcomes. The majority of patients surviving the acute event are still alive at 1 year, but evidence on quality of life is scarce.Clinical suspicion of AMI is the key to timely diagnosis, with biphasic computed tomography-angiography the diagnostic method of choice. Currently, no biomarker has sufficient specificity to diagnose AMI.SummaryImproved awareness and knowledge of AMI are needed to raise the suspicion of AMI in relevant patients and thereby to achieve better outcomes.

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“…Although the precise mechanisms accounting for these involvements remain poorly understood, thromboembolic episodes could occur more frequently in COVID-19 patients [6] . A recent study showed that non-occlusive mesenteric ischemia was the most common pattern suggestive of microvascular involvement [7] . In addition other ischemic damages have been reported such as renal infarctions, which was commonly identified on abdominal CT [4] and similarly, a high incidence of acute adrenal infarction have been reported on initial chest CT in severe COVID-19 patients, which might be a sign of a poorer prognosis [8] .…”

Section: Introductionmentioning

confidence: 99%