A Rare Case of Acute Mesenteric Ischemia in the Setting of COVID-19 Infection

Krothapalli, Neeharika; Jacob, Jason

doi:10.7759/cureus.14174

Cited by 8 publications

(23 citation statements)

References 14 publications

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“…A alta prevalência de sintomas gastrointestinais durante a infecção pelo COVID-19, concomitante à alta mortalidade da IMA (60-80%) 8 e a incidência aumentada de IMA em pacientes com COVID-19 (em torno de 1.9 a 3.8%, maior que na população geral) 4 , justificam a necessidade de suspeição diagnóstica precoce associada à realização de AngioTC já no início do quadro clínico, para que seja definida a abordagem 8 . Tanto nos casos B e C quanto em outros estudos 4,15 AngioTC não foi realizada inicialmente, retardando o diagnóstico. Em contraste, em um estudo publicado em Omã 8 , houve suspeita de IMA logo no início e a AngioTC foi realizada prontamente, o que levou a melhor manejo com tratamento cirúrgico precoce e maior sobrevida.…”

Section: Discussionunclassified

Isquemia Mesentérica Aguda Como Complicação Tromboembólica Da Covid-19: Relato De Três Casos

Nassif¹,

Rucinski²,

Rota³

et al. 2022

Relatos Casos Cir.

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Introdução: A Isquemia Mesentérica Aguda (IMA) é uma emergência abdominal grave relacionada ao estado de hipercoagulabilidade causada pela COVID-19 com alta taxa de mortalidade. Presume-se que pode ocorrer como uma característica da apresentação inicial ou uma complicação tardia do COVID-19. Relato do caso: Foi realizada a análise descritiva de 3 casos de pacientes diagnosticados com COVID-19 e IMA na evolução do quadro, com diferentes abordagens diagnósticas e terapêuticas. Conclusão: A elevada morbimortalidade decorrente da IMA justifica a necessidade de alta suspeição em pacientes que apresentam dor abdominal aguda associada ao quadro de COVID-19. A angio TC deve ser realizada prontamente para que a abordagem terapêutica seja a melhor possível. Palavras-chave: COVID-19. Isquemia Mesentérica. Abdome Agudo. Tromboembolia

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Section: Discussionunclassified

Isquemia Mesentérica Aguda Como Complicação Tromboembólica Da Covid-19: Relato De Três Casos

Nassif¹,

Rucinski²,

Rota³

et al. 2022

Relatos Casos Cir.

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“…It has been documented that COVID‐19 leads AMI. 33 , 39 This has often been attributed to the hypercoagulable state that the novel coronavirus puts the patient's body in, which eventually leads to bowel ischaemia. 40 The importance of early diagnosis and prevention cannot be stated enough.…”

Section: Discussionmentioning

confidence: 99%

Bowel ischemia in COVID‐19: A systematic review

Patel

Parikh

Verma

et al. 2021

Int J Clinical Practice

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Background Gastrointestinal complications of COVID‐19 have been reported over the last year. One such manifestation is bowel ischaemia. This study thus aims to provide a more holistic review of our current understanding of COVID‐19‐induced bowel ischaemia. Method and Results A meticulous search was performed using different keywords in PubMed and Google Scholar. Fifty‐two articles were included in our study after applying inclusion and exclusion criteria and performing the qualitative assessment of the studies. A total of 25 702 patients were included in our study after the completion of the qualitative assessment. Discussion The common symptoms of GIT in COVID‐19 patients are as diarrhoea, vomiting, nausea and abdominal pain. The mechanism of bowel ischaemia is associated with the formation of emboli which is related to COVID‐19’s high affinity for angiotensin‐converting enzyme‐2 on enterocytes, affecting the superior mesenteric vessels. Clinically, patients present with abdominal pain and vomiting. CT angiography of the abdomen and pelvis showed acute intestinal ischaemia (mesenteric). Management is usually initiated with gastric decompression, fluid resuscitation, and haemodynamic support. Surgical intervention is also sought. Conclusion Intestinal ischaemia presenting in patients with COVID‐19 has to be considered when symptoms of severe abdominal pain are present. More research and guidelines are required to triage patients with COVID‐19 to suspect intestinal ischaemia and to help in diagnosis and management.

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“…Acute mesenteric ischemia has a poor prognosis, and life is reliant on prompt diagnosis and treatment. If detected within 24 h, the likelihood of survival is 50%, but it declines to 30% beyond that [ 17 ].In operated cases, COVID infection acts as an independent risk factor and is responsible for higher mortality [ 18 ].…”

Section: Prognosismentioning

confidence: 99%

Review of Mesenteric Ischemia in COVID-19 Patients

et al. 2022

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The new coronavirus (COVID-19) infection, first detected in Wuhan, China in 2019 has become a pandemic that has spread to nearly every country in the world. Through October 11, 2021, more than 23 billion confirmed cases and 4.8 million fatalities were reported globally. The bulk of individuals afflicted in India during the first wave were elderly persons. The second wave, however, resulted in more severe diseases and mortality in even younger age groups due to mutations in the wild virus. Symptoms may range from being asymptomatic to fatal acute respiratory distress syndrome (ARDS). In addition to respiratory symptoms, patients may present with gastrointestinal symptoms such as stomach pain, vomiting, loose stools, or mesenteric vein thrombosis. The frequency of patients presenting with thromboembolic symptoms has recently increased. According to certain studies, the prevalence of venous thromboembolism among hospitalized patients ranges from 9 to 25%. It was also shown that the incidence is significantly greater among critically sick patients, with a prevalence of 21–31%. Although the exact origin of thromboembolism is unknown, it is considered to be produced by several altered pathways that manifest as pulmonary embolism, myocardial infarction, stroke, limb gangrene, and acute mesenteric ischemia. Acute mesenteric ischemia (AMI) is becoming an increasingly prevalent cause of acute surgical abdomen in both intensive care unit (ICU) and emergency room (ER) patients. Mesenteric ischemia should be evaluated in situations with unexplained stomach discomfort. In suspected situations, appropriate imaging techniques and early intervention, either non-surgical or surgical, are necessary to avert mortality. The purpose of this article is to look at the data on acute mesenteric ischemia in people infected with COVID-19.

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A Rare Case of Acute Mesenteric Ischemia in the Setting of COVID-19 Infection

Cited by 8 publications

References 14 publications

Isquemia Mesentérica Aguda Como Complicação Tromboembólica Da Covid-19: Relato De Três Casos

Isquemia Mesentérica Aguda Como Complicação Tromboembólica Da Covid-19: Relato De Três Casos

Bowel ischemia in COVID‐19: A systematic review

Review of Mesenteric Ischemia in COVID-19 Patients

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