Bowel necrosis in patient with severe case of COVID-19: a case report

Soeselo, Daniel Ardian; Hambali, Wirawan; Theresia, Sandy

doi:10.1186/s12893-021-01104-7

Cited by 7 publications

(11 citation statements)

References 13 publications

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“…The symptoms and signs of intestinal ischemia were initiated 7 days following the respiratory manifestations of COVID-19. The precedence of respiratory manifestations has also been mentioned in the previous studies ( 6 , 7 , 10 , 11 , 26 ). However, some studies report the concomitant PCR confirmation of COVID-19 and intestinal ischemia ( 7 , 8 , 12 ).…”

Section: Discussionsupporting

confidence: 70%

“…It is noteworthy that a normal CRP and D-dimer may not necessarily rule out intestinal ischemia. Soeselo et al describe a patient with gastrointestinal manifestations and normal CRP and D-dimer, diagnosed with intestinal necrosis and perforation ( 10 ). Based on what was mentioned, the predictive value of CRP and D-dimer are best interpreted based on the clinical presentations.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 and Intestinal Ischemia: A Multicenter Case Series

et al. 2022

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IntroductionGastrointestinal symptoms are common among COVID-19 patients. Although gastrointestinal involvements are mostly benign, they rarely indicate a severe pathology like intestinal ischemia. The present case series describes 21 patients with bowel ischemia, necrosis, or perforation.MethodsThe present case series was conducted from April 2020 to February 2022 in the surgical wards of two Iranian hospitals. We retrospectively included adult patients with concomitant COVID-19 and intestinal ischemia. Primary outcomes were defined as the length of stay and survival.ResultsTwenty-four patients with a median age of 61.5 years were included in the study. Sixteen (67%) patients were male, and 13 (54%) were without any comorbidities. Macrovascular mesenteric ischemia was not identified in 21 patients (87.5%). Gastrointestinal manifestations appeared on the median of seven days (range 2–21) after the diagnosis of COVID-19, with the most common symptom being abdominal pain. All the patients had a significantly elevated C-Reactive Protein prior to surgery, ranging from 68 to 362. D-dimer was measured in eight patients and was significantly elevated, ranging from 1,878 to over 5,000 ng/mL. One patient was managed conservatively due to a good clinical condition. Except for one patient with angioinvasive mucormycosis and one other with leukocytoclastic vasculitis, pathologic evaluation revealed general features of intestinal necrosis, including ulcer, hemorrhage, necrosis, neutrophilic infiltration (in seven patients), neutrophilic abscess (in four patients), and edema. Bowel necrosis accompanied mortality of 15 (62.5%) patients and a median of 6.5 days of hospital stay.ConclusionIntestinal ischemia in COVID-19 patients is associated with a high mortality rate. Further research is needed to elucidate the dynamics of intestinal ischemia in the setting of COVID-19.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

COVID-19 and Intestinal Ischemia: A Multicenter Case Series

et al. 2022

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“…In the UK, during this pandemic, Soeselo et al presented the first case report of SARS-CoV-2 infection that directly infected the appendix, causing acute appendicitis, in which highly atypical histopathological features such as microthrombi, perivascular lymphocytic infiltrates and infarction were found and confirmed by a polymerase chain reaction of appendicular tissue sample which was positive 19 . Intraluminal pathologies probably play a major role in the development of acute appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of histopathological findings of patients presenting with acute appendicitis in COVID-19 infected and non-COVID-19 infected patients.

Shaikh

Sajjad

Ramzan

et al. 2022

Int. j. endorsing health sci. res.

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Background: COVID-19 disease has been associated with multiple organs and causes various symptoms depending on the organ involved. Histological findings in the lungs, such as microthrombi, perivascular lymphocytic infiltrate, and necrosis/infarction, can also be seen in the histopathology of the appendix of COVID-19 +ve patients. Methodology: This cross-sectional study was conducted in Dr. Ziauddin Hospital, a tertiary care center in Karachi, Pakistan. In this research article, the histopathology reports of the appendix of COVID-19 +ve patients presenting with acute appendicitis, either antigen or PCR positive, are compared with those of non-COVID patients who presented with acute appendicitis. The data was analyzed using SPSS 20.0, and Pearson’s Chi-Square and Cramer's V tests were performed for analysis. Results: Comparing the histopathology reports of COVID-19 +ve and non-COVID patients presenting with acute appendicitis, an appendix of COVID-19 +ve patients shows microthrombi; perivascular lymphocytic infiltrates, and necrosis/infarction. Conclusion: Patients who are COVID-19 +ve presenting with acute appendicitis should be treated surgically as soon as possible to reduce the risk of acute presentation, ultimately leading to perforation, and not wait for the patient to recover from COVID infection first.

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“…COVID-19 has been linked to gastrointestinal disease in adults [ 14 ], with several reports of perforation throughout the small and large bowel [ [15] , [16] , [17] ]. In many of these cases, intestinal necrosis and perforation have been ascribed to thrombo-embolic events caused by COVID-related hypercoagulability [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Premature twin neonates with a Coronavirus-19 positive mother present with an unusual pattern of intestinal ischemia

Retajczyk

Jaffee

McKim

et al. 2022

Journal of Pediatric Surgery Case Reports

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COVID-19 infection during pregnancy is associated with premature rupture of membranes, preterm delivery, and low birth weight. It has also been associated with hypercoagulability and vasculitis in certain patients. This article reports two premature twins born from a COVID-19 mother who presented with an unusual pattern of ileal ischemia and perforation within 24 hours of each other. We suggest that maternal infection with the novel coronavirus might lead to this atypical distribution of intestinal pathology.

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Bowel necrosis in patient with severe case of COVID-19: a case report

Cited by 7 publications

References 13 publications

COVID-19 and Intestinal Ischemia: A Multicenter Case Series

COVID-19 and Intestinal Ischemia: A Multicenter Case Series

Comparison of histopathological findings of patients presenting with acute appendicitis in COVID-19 infected and non-COVID-19 infected patients.

Premature twin neonates with a Coronavirus-19 positive mother present with an unusual pattern of intestinal ischemia

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