Coronavirus 2019 (COVID-19) is associated with a high incidence of thromboembolic events. Patients with severe form have a higher risk as well as those with embolic factors (high age, obesity, diabetes, etc.). Acute mesenteric thrombosis is among the complications to be feared during this pandemic even in patients who do not have embologenic factors. The objective of this study is to discuss and understand the mechanism of occurrence of acute mesenteric thrombosis during COVID-19 infection. The case studied is about an old woman (64 years old) with only recent history of covid-19 infection who consults for acute abdominal pain with occlusive syndrome. Thoracoabdominal CT showed superior mesenteric arterial and venous thrombosis and bilateral mid-lobe pneumonia. The patient progressed well on anticoagulant therapy. Rare cases of mesenteric ischemia secondary to vein and/or mesenteric artery thrombosis have been described during this pandemic; this requires therapeutic and preventive management of thromboembolic disease in patients to reduce mortality of this disease.
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Fouad, S. , Hicham, K. , Nizar, E. , Mohammed, C. , Abdessamad, E. K. , Said, B. , Ali, Z. , Brahim, Z. , Mohammed, M. , Samir, H. and Abdelkarim, C. (2022). Acute Mesenteric Thrombosis in COVID-19: A Case Report. Open Access Library Journal, 9, e8949. doi: http://dx.doi.org/10.4236/oalib.1108949.
Maatman, T.K., Jalali, F., Feizpour, C., Douglas, A., McGuire, S.P., Kinnaman, G., et al. (2020) Routine Venous Thromboembolism Prophylaxis may Be Inadequate in the Hypercoagulable State of Severe Coronavirus Disease 2019. Critical Care Medicine, 48, e783-e790. https://doi.org/10.1097/CCM.0000000000004466
Klok, F.A., Kruip, M.J.H.A., van der Meer, N.J.M., Arbous, M.S., Gommers, D., Kant, K.M., et al. (2020) Confirmation of the High Cumulative Incidence of Thrombotic Complications in Critically Ill ICU Patients with COVID-19: An Updated Analysis. Thrombosis Research, 191, 148-150.
https://doi.org/10.1016/j.thromres.2020.04.041
Spiezia, L., Boscolo, A., Poletto, F., Cerruti, L., Tiberio, I., Campello, E., et al. (2020) COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure. Journal of Thrombosis and Haemostasis, 120, 998-1000. https://doi.org/10.1055/s-0040-1710018
Fox, S.E., Akmatbekov, A., Harbert, J.L., et al. (2020) Pulmonary and Cardiac Pathology in African American Patients with COVID-19: An Autopsy Series from New Orleans. The Lancet Respiratory Medicine, 8, 681-686.
https://doi.org/10.1016/S2213-2600(20)30243-5
Parry, A.H., Wani, A.H. and Yaseen, M. (2020) Acute Mesenteric Ischemia in Severe Coronavirus-19 (COVID-19): Possible Mechanisms and Diagnostic Pathway. Academic Radiology, 27, Article No. 1190.
https://doi.org/10.1016/j.acra.2020.05.016
Panigada, M., Bottino, N., Tagliabue, P., et al. (2020) Hypercoagulability of COVID-19 Patients in Intensive Care Unit: A Report of Thromboelastography Findings and other Parameters of Hemostasis. Journal of Thrombosis and Haemostasis, 18, 1738-1742.
https://doi.org/10.1111/jth.14850
Cheung, S., Quiwa, J.C., Pillai, A., et al. (2020) Superior Mesenteric Artery Thrombosis and Acute Intestinal Ischemia as a Consequence of COVID-19 Infection. American Journal of Case Reports, 21, e925753.
https://doi.org/10.12659/AJCR.925753
Fan, B.E., Chang, C.C.R., Teo, C.H.Y., et al. (2020) COVID-19 Coagulopathy with Superior Mesenteric Vein Thrombosis Complicated by an Ischaemic Bowel. Hamostasisology, 40, 592-593. https://doi.org/10.1055/a-1232-7446
Goh, S.S.N., Yong, E.M., Hong, Q.T., et al. (2020) Acute Aortic Thrombosis Presenting as Acute Limb Ischemia in Two Young, Non Atherosclerotic Patients. British Journal of Surgery, 107, e565–e566, https://doi.org/10.1002/bjs.11897
Tang, N. (2020) Anticoagulant Therapy is Associated with a Decrease in Blood Mortality in Patients with Severe Coronavirus Disease 2019 with Coagulopathy. Journal of Thrombosis and Haemostasis, 18, 1094-1099.
https://doi.org/10.1111/jth.14817