Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
Indian J Gastroenterol. 2022 Jun;41(3):313-318. doi: 10.1007/s12664-022-01260-5. Epub 2022 Jul 30.
Involvement of the gastrointestinal (GI) system in corona virus disease-19 (COVID-19) in form of diarrhea, loss of taste, nausea, and anorexia is common and associated with poor prognosis. COVID-19 is also associated with a hypercoagulable state that mainly involves the pulmonary vasculature. However, GI complications involving thrombosis are observed infrequently. We report two COVID-19 patients who had two different causes of acute abdomen. The first patient was a 49-year-old male diagnosed with an aortic thrombus along with a splenic infarct. He was diagnosed early and successfully managed with anticoagulants. The second patient was a 30-year-old male who developed pain in the abdomen and was found to have features suggestive of peritonitis. A contrast-enhanced computerized tomography (CECT) scan of the abdomen revealed dilated bowel loops. Immediate exploratory laparotomy was performed; he was found to have jejunal perforation with gangrene. Histopathological examination of the resected specimen showed inflammatory cells with edema and thrombotic vessels. However, he succumbed to sepsis and multiorgan failure. Therefore, it is important to investigate cases of acute abdomen in COVID-19 thoroughly and whenever indicated CT angiogram should be obtained.
胃肠道（GI）系统在冠状病毒病-19（COVID-19）中的受累表现为腹泻、味觉丧失、恶心和厌食，较为常见，并与预后不良有关。COVID-19还与主要涉及肺血管的高凝状态有关。然而，很少观察到涉及血栓形成的胃肠道并发症。我们报告了两名 COVID-19 患者，他们有两种不同原因的急性腹痛。第一例患者是一名 49 岁男性，被诊断为主动脉血栓形成和脾梗死。他得到了早期诊断，并成功地接受了抗凝治疗。第二例患者是一名 30 岁男性，出现腹痛，并发现有腹膜炎的特征。腹部增强计算机断层扫描（CECT）显示肠袢扩张。立即进行剖腹探查术，发现空肠穿孔伴坏死。切除标本的组织病理学检查显示有炎症细胞伴水肿和血栓性血管。然而，他最终死于脓毒症和多器官衰竭。因此，在 COVID-19 中彻底调查急性腹痛病例非常重要，并且在有指征时应进行 CT 血管造影检查。
