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COVID-19 引起的肠缺血的迟发表现。

A Late Presentation of COVID-19 Induced Bowel Ischemia.

机构信息

Department of Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, Texas.

出版信息

CRSLS. 2022 Nov 22;9(4). doi: 10.4293/CRSLS.2022.00057. eCollection 2022 Oct-Dec.

Abstract

INTRODUCTION

Infection with COVID-19 may lead to extrapulmonary pathologies secondary to the systemic inflammatory effects of the virus.

CASE DESCRIPTION

This case report discusses a 55-year-old female patient who presented with small bowel obstruction (SBO) several months after resolution of a COVID-19 infection. The patient was surgically treated with a small bowel resection, and eventually made a full recovery.

DISCUSSION

The pathophysiology of COVID-19-induced SBO can be explained by the prolonged inflammation and coagulation activation in the bowel's vasculature system. Under these circumstances, microthrombosis occurs in the bowel's microvasculature; the affected intestinal tissue becomes ischemic and infarcted. The damaged bowel is eventually replaced with fibrotic scar tissue, thus promoting bowel stricture and subsequent obstruction.

CONCLUSION

COVID-19 can be responsible for both acute and chronic embolic and thrombotic events in the mesenteric vasculature, which acts as a risk factor in the manifestation of SBO.

摘要

简介

COVID-19 感染可能会导致肺部以外的疾病,这是由于病毒的全身炎症反应所致。

病例描述

本病例报告讨论了一位 55 岁女性患者,她在 COVID-19 感染痊愈后数月出现小肠梗阻(SBO)。该患者接受了小肠切除术的手术治疗,最终完全康复。

讨论

COVID-19 引起的 SBO 的病理生理学可以通过肠道血管系统中炎症和凝血激活的延长来解释。在这种情况下,肠道微血管发生微血栓形成;受影响的肠组织发生缺血和梗死。受损的肠道最终被纤维疤痕组织取代,从而导致肠狭窄和随后的梗阻。

结论

COVID-19 可导致肠系膜血管中的急性和慢性栓塞和血栓形成事件,这是 SBO 表现的一个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c24/9682609/5a19cc300bdf/LS-JSLS220059F001.jpg

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