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Thrombosis leading to acute abdomen in corona virus disease- 19:A case series

Zia Hashim1, Ajmal Khan2, Prasant Areekkara2

  • 1Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India. ziasgpgi@gmail.com.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|July 30, 2022
PubMed

Insights

Gastrointestinal complications, including thrombosis, can occur in COVID-19 patients with acute abdomen. Early diagnosis and intervention are crucial for better outcomes in these severe cases.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Gastrointestinal (GI) symptoms are common in coronavirus disease-19 (COVID-19) and linked to poor prognosis.
  • COVID-19 is associated with a hypercoagulable state, primarily affecting pulmonary vasculature.
  • GI complications involving thrombosis are infrequently observed but can be severe.

Observation:

  • Two cases of COVID-19 presenting with acute abdomen due to different causes are reported.
  • Case 1: A 49-year-old male with aortic thrombus and splenic infarct, managed successfully with anticoagulants.
  • Case 2: A 30-year-old male with jejunal perforation and gangrene, leading to sepsis and multiorgan failure.

Findings:

  • Histopathology revealed inflammatory cells, edema, and thrombotic vessels in the resected jejunal specimen.
  • The study highlights the diverse GI manifestations of COVID-19, including rare thrombotic events.
  • Prompt investigation of acute abdomen in COVID-19 patients is essential.

Implications:

  • Thrombotic events in the GI tract should be considered in COVID-19 patients with acute abdominal symptoms.
  • CT angiography may be indicated for thorough investigation of suspected GI vascular complications.
  • Timely diagnosis and management of GI complications in COVID-19 can impact patient outcomes.

Keywords:
AngiogramCOVID-19Disease managementGastrointestinalIntestinal perforationMesenteric ischemiaMultiple organ failureSARS-CoV-2Splenic infarctionThrombophilia

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