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轻度新型冠状病毒肺炎中肠系膜上静脉闭塞的罕见表现

An Unusual Presentation of Superior Mesenteric Venous Occlusion in Mild COVID-19.

作者信息

Batra Sakshi, Nair Asha G, Syal Kirtimaan

机构信息

Department of Pulmonary Medicine, Sir Ganga Ram Hospital, New Delhi, India.

Department of Pulmonary Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, India.

出版信息

Indian J Clin Biochem. 2023 Apr;38(2):275-278. doi: 10.1007/s12291-022-01067-3. Epub 2022 Aug 10.

Abstract

SARS-CoV-2, an etiological agent of COVID-19, has been reported to inflict remarkably diverse manifestations in different subjects across the globe. Though patients with COVID-19 predominantly have fever, respiratory and constitutional symptoms, atypical presentations are becoming increasingly evident. COVID-19 may predispose to both venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilization, and diffuse intravascular coagulation in moderate to severe symptomatic cases. In this case report, we are reporting thromboembolic complications of COVID-19 in a mild symptomatic subject incidentally diagnosed with mesenteric venous occlusion with no abdominal symptoms. Early recognition of the abdominal symptoms, diagnosis, initiation of anticoagulants, and timely surgical intervention may improvise the outcome in a patient with COVID-19 infection-induced mesenteric thrombosis. Superior mesenteric artery and venous thrombosis may lead to subsequent ischemia necessitating emergency laparotomy. Thus, the usage of low-dose anticoagulants in all the patients of COVID-19 irrespective of the categorization into mild, moderate, and severe COVID-19 disease should be considered.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是冠状病毒病(COVID-19)的病原体,据报道,它在全球不同个体中会引发极为多样的症状表现。虽然COVID-19患者主要表现为发热、呼吸道症状和全身症状,但非典型症状正变得越来越明显。在中重度症状病例中,由于过度炎症、缺氧、制动和弥漫性血管内凝血,COVID-19可能导致静脉和动脉血栓栓塞。在本病例报告中,我们报告了一名症状轻微的COVID-19患者出现血栓栓塞并发症,该患者偶然被诊断为肠系膜静脉闭塞,且无腹部症状。早期识别腹部症状、诊断、启动抗凝治疗以及及时进行手术干预,可能会改善COVID-19感染引起的肠系膜血栓形成患者的预后。肠系膜上动脉和静脉血栓形成可能导致随后的缺血,需要紧急剖腹手术。因此,无论COVID-19疾病被分类为轻度、中度还是重度,都应考虑在所有COVID-19患者中使用低剂量抗凝剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cef8/10070551/112b8725251b/12291_2022_1067_Fig1_HTML.jpg

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