Alyousef Israa A, Alsaileek Zainab A, Alabdulsalam Manar A, Almohanna Muhannad A, Alshaqhaa Naif A, Alqahtani Mohammed M, Al Alyany Anas A, Alzahrani Muhannad A, Fallatah Hawazin A, Alqadhib Jalal I, Alhawsawi Abdulaziz M, Alsuhaymi Abdulelah D, Alasmari Ali M, Alshareef Abdullah J, Al-Hawaj Faisal
College of Medicine, Dar Al Uloom University, Riyadh, SAU.
College of Medicine, Qassim University, Buraydah, SAU.
Cureus. 2022 Jan 17;14(1):e21314. doi: 10.7759/cureus.21314. eCollection 2022 Jan.
Coronavirus disease 2019 (COVID-19) typically involves the respiratory system, but gastrointestinal involvement is common. Further, patients with severe COVID-19 are at high risk to develop gastrointestinal complications, including bowel ischemia, ileus, and deranged liver enzymes. We present the case of a 44-year-old woman with mild COVID-19 pneumonia who was in home isolation. Ten days after the isolation, the patient presented to the emergency department complaining of generalized abdominal pain that was sharp in nature and associated with nausea and recurrent episodes of vomiting. The patient did not complain of any respiratory symptoms. Physical examination showed diffuse tenderness with no clinical signs to suggest generalized peritonitis. The laboratory parameters showed normal hematological, renal, and hepatic profiles. No elevation in the inflammatory markers was observed. The amylase level was within the normal range. Abdominal computed tomography scan demonstrated the presence of misty mesentery with increased density of the mesentery with fat stranding encasing the mesenteric vessels along with mesenteric adenopathy. Such radiological features suggested the diagnosis of mesenteric panniculitis. Subsequently, intravenous corticosteroid therapy was initiated and the patient exhibited significant improvement after 24 hours. The patient was discharged after nine days of hospitalization. She was followed up after one month and she had no complaints. Mesenteric panniculitis is a rare idiopathic inflammatory condition involving the mesenteric adipose tissue. The case shed a light on the possible association of COVID-19 with mesenteric panniculitis. The clinical manifestations of mesenteric panniculitis are non-specific and imaging studies are essential to suggest the diagnosis.
2019冠状病毒病（COVID-19）通常累及呼吸系统，但胃肠道受累也很常见。此外，重症COVID-19患者发生胃肠道并发症的风险很高，包括肠缺血、肠梗阻和肝酶紊乱。我们报告一例44岁轻症COVID-19肺炎女性患者，她正在居家隔离。隔离10天后，患者因突发全腹剧痛、伴有恶心和反复呕吐就诊于急诊科。患者无任何呼吸道症状。体格检查显示弥漫性压痛，无提示弥漫性腹膜炎的临床体征。实验室检查参数显示血液学、肾脏和肝脏指标正常。未观察到炎症标志物升高。淀粉酶水平在正常范围内。腹部计算机断层扫描显示肠系膜模糊，肠系膜密度增加，脂肪条索包绕肠系膜血管，伴有肠系膜淋巴结肿大。这些影像学特征提示肠系膜脂膜炎的诊断。随后，开始静脉注射皮质类固醇治疗，患者在24小时后病情显著改善。住院9天后患者出院。出院后1个月进行随访，患者无不适主诉。肠系膜脂膜炎是一种罕见的特发性炎症性疾病，累及肠系膜脂肪组织。该病例揭示了COVID-19与肠系膜脂膜炎之间可能存在的关联。肠系膜脂膜炎的临床表现不具有特异性，影像学检查对于提示诊断至关重要。
