Rodriguez-Nakamura RM, Gonzalez-Calatayud M, Martinez Martinez AR. Acute mesenteric thrombosis in two patients with COVID-19. Two cases report and literature review.
Int J Surg Case Rep 2020;
76:409-414. [PMID:
33083204 PMCID:
PMC7560267 DOI:
10.1016/j.ijscr.2020.10.040]
[Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION
The coronavirus disease 2019 (COVID-19) affects mainly the respiratory system, other organs may be involved, usually due to coagulation disturbances that lead to a high rate of thrombotic complications.
CASE PRESENTATION
The first patient is 45 years-old who has been exposed to SARS CoV-2. Upon admission due to acute abdomen evidence surgery is performed in which an intestinal resection with an adequate post-surgical evolution takes place so the patient is discharged after 4 days with a prescription for oral anticoagulants. The second one is 42 years-old and has comorbidities. The patient is admitted upon evidence of COVID-19, after showing signs of vein mesenteric ischemia in a CT scan surgery is performed, however the patient dies 24 h after the intervention.
DISCUSSION
Within severe cases of patients with COVID-19 the incidence of a symptomatology or gastrointestinal complications is high (39-73.8%). Thromboprophylaxis is recommended to all patients admitted for COVID-19, starting with heparin of low molecular weight as prophylaxis, as well as continuing with oral anticoagulants after being discharged.
CONCLUSION
Despite the fact that knowledge of the disease is rapidly advancing, all available treatments are still nonspecific to SARS-CoV-2 and the optimal management of COVID-19 remains unclear. An unexplained clinical picture should raise the suspicion for rare conditions such as mesenteric thrombosis. Adequate prophylactic measures should be implemented both during hospitalization and after discharge.
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