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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric Infarction With Cerebral Thrombotic Relapses and Pulmonary Embolism Two and Four Months After COVID-19
Henrique Jose Pereira de Godoy1, Guilherme Marum Olmedo2, Jose Maria Pereira de Godoy3,4
1Department of General Surgery, Medicine School in Sao Jose do Rio Preto, FAMERP, Brazil.
Insights
This study details a COVID-19 patient
Area of Science:
- Internal Medicine
- Infectious Diseases
- Cardiovascular Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is associated with thrombotic complications.
- Understanding the spectrum of thrombotic events post-COVID-19 is crucial for patient management.
Observation:
- A 49-year-old obese patient with COVID-19 developed acute mesenteric infarction.
- Two months later, the patient experienced a stroke.
- Four months post-infection, pulmonary thromboembolism was diagnosed.
Findings:
- The patient presented with COVID-19 symptoms including myalgia and headache.
- Exploratory laparotomy confirmed mesenteric ischemia.
- Cerebral angiotomography revealed signs of stroke.
- Chest angiotomography showed pulmonary thromboembolism.
Implications:
- COVID-19 can lead to diverse and delayed thrombotic events affecting multiple organ systems.
- This case highlights the importance of vigilant monitoring for thromboembolic phenomena in post-COVID-19 patients.
- Early recognition and intervention are critical for improving outcomes in patients with severe COVID-19 complications.
Abstract:
The aim of the present study was to report different sites of thrombotic events during and after coronavirus disease 2019 (COVID-19) in a 49-year-old patient who had acute mesenteric infarction in acute phase, stroke 2 months after and pulmonary thromboembolism 4 months after infection by COVID-19. The obese, previously healthy patient experienced myalgia and headache with subfebrile peaks and was tested positive for COVID-19 with a fast polymerase chain reaction (PCR) assay. Ten days after the onset of symptoms, the patient was submitted to exploratory laparotomy, which revealed 20 cm of small intestine loop with signs of suffering and thickening of the wall approximately 120 cm from the ileocecal valve. Two months after the event, angiotomography was performed, revealing effacement of the sulci in the right parietal region and hypersignal of the right middle cerebral artery with stop in M1. Two months later (4 months after the mesenteric infarction), chest angiotomography revealed signs of acute pulmonary thromboembolism, with no typical image of pulmonary infarction. Despite all these complications in the postoperative period, the patient survived.
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