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Colonic Perforation Secondary to COVID-19 Induced Hemorrhagic Colitis in a Patient Heterozygous for Factor V Leiden

Nicole Gherlone1, Priya Bhakta2, Marsha Apushkin3

  • 1Department of Surgery, Ascension St Joseph's Hospital, Chicago, IL, USA.

The American Surgeon
|May 4, 2023
PubMed

Insights

This case report details a COVID-19 patient who developed hemorrhagic colitis and colonic perforation. Indocyanine green (ICG) assessed perfusion, highlighting the need for hypercoagulable evaluation post-COVID-19.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Case Reports

Background:

  • Gastrointestinal symptoms affect a significant portion of COVID-19 patients.
  • Bowel abnormalities are reported in up to 31% of COVID-19 positive individuals.

Observation:

  • A 40-year-old male with COVID-19 presented with hemorrhagic colitis.
  • Imaging revealed colonic distension, pneumatosis, and pneumoperitoneum, necessitating emergent surgery.
  • The patient was found to be heterozygous for factor V Leiden mutation and unvaccinated.

Findings:

  • Surgical intervention included extended left hemicolectomy and transverse colostomy.
  • Indocyanine green (ICG) was utilized for intraoperative perfusion assessment.
  • A heterozygous factor V Leiden mutation was identified.

Implications:

  • This case highlights a novel application of indocyanine green (ICG) in assessing surgical site perfusion.
  • It underscores the critical importance of comprehensive hypercoagulable state evaluation in COVID-19 patients experiencing thrombotic events.
  • COVID-19 can precipitate severe gastrointestinal complications requiring surgical management.

Keywords:
COVID-19colorectalcoronavirusindocyanine green

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