Costanzo Louis, Karki Bhesh R, Soto Brian, Falb Vladimir, Page Cameron
Internal Medicine, Downstate-Health Sciences University of New York, Brooklyn, USA.
Cureus. 2023 Jan 1;15(1):e33220. doi: 10.7759/cureus.33220. eCollection 2023 Jan.
An 86-year-old woman with a recent hospitalization for severe coronavirus disease 2019 (COVID-19) infection presented to the emergency department with abdominal discomfort and bilateral leg swelling. She was mildly tachycardic on physical exam, with superficial abdominal vessel dilation and bilateral lower extremity edema. Her laboratory results were significant for a mildly elevated lipase of 260 U/L (normal range: 0-160 U/L) and a positive COVID-19 PCR test. CT of the abdomen and pelvis did not show any pancreatic abnormality but revealed a duplicated inferior vena cava (IVC) with a thrombus located in the right IVC. The patient was subsequently placed on full-dose anticoagulation with the eventual achievement of clot lysis. It appears that the incidence of thrombosis, including IVC thrombosis, has been on the rise due to COVID-19-associated coagulopathy; therefore, a high index of clinical suspicion in these cases may prove to be lifesaving.
一名86岁女性因近期因严重的2019冠状病毒病（COVID-19）感染住院，现因腹部不适和双侧腿部肿胀到急诊科就诊。体格检查时她有轻度心动过速，伴有腹部浅表血管扩张和双侧下肢水肿。她的实验室检查结果显示脂肪酶轻度升高至260 U/L（正常范围：0-160 U/L），COVID-19 PCR检测呈阳性。腹部和骨盆CT未显示胰腺有任何异常，但发现下腔静脉（IVC）重复畸形，右IVC内有血栓形成。该患者随后接受了全剂量抗凝治疗，最终实现了血栓溶解。由于COVID-19相关凝血病，包括IVC血栓形成在内的血栓形成发生率似乎一直在上升；因此，在这些病例中保持高度的临床怀疑可能会挽救生命。
