Cirugía General, Clínica Universidad de Navarra.
Cirugía General, Clínica Universidad de Navarra, España.
Rev Esp Enferm Dig. 2020 Oct;112(10):784-787. doi: 10.17235/reed.2020.7329/2020.
COVID-19 is associated with severe coagulopathy. We present three cases of colonic ischemia that can be attributed to the hypercoagulable state related with SARS-CoV2 and disseminated intravascular coagulation. Three males aged 76, 68 and 56 with respiratory distress presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia. One patient (case 2) in which a computed tomography (CT) scan showed perforation of the gangrenous cecum underwent surgery. D-dimer levels were markedly increased (2,170, 2,100 and 7,360 ng/ml) in all three patients. All three patients died shortly after diagnosis.
COVID-19 与严重的凝血功能障碍有关。我们报告了三例结肠缺血的病例，这些病例可归因于与 SARS-CoV2 和弥散性血管内凝血相关的高凝状态。三名男性，年龄分别为 76 岁、68 岁和 56 岁，均有呼吸窘迫症状，出现直肠出血、腹胀和腹膜刺激征。内镜检查（病例 1）和计算机断层扫描血管造影显示结肠缺血。一名患者（病例 2）的计算机断层扫描（CT）显示坏疽性盲肠穿孔，接受了手术治疗。所有三名患者的 D-二聚体水平均显著升高（2170、2100 和 7360ng/ml）。三名患者在诊断后不久均死亡。
