Mahdi Ahmad, Bharwad Aastha, Mahdi Mahmoud, Rowe Kyle
Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, USA.
Cureus. 2023 Mar 16;15(3):e36251. doi: 10.7759/cureus.36251. eCollection 2023 Mar.
Coronavirus disease (COVID-19) is primarily a respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. However, the disease is also known to cause a range of extrapulmonary manifestations, including gastrointestinal (GI) symptoms such as nausea, vomiting, and diarrhea. The exact mechanisms by which the virus causes extrapulmonary manifestations are not fully understood, but it is theorized that the virus can enter cells in other organs including the GI tract, through the angiotensin-converting enzyme 2 (ACE2) receptor. This can result in inflammation and damage to the affected organs. In rare cases, COVID-19 can also cause acute colonic pseudo-obstruction (ACPO), a condition characterized by symptoms of bowel obstruction but without a physical obstruction present. Acute colonic pseudo-obstruction is a serious and potentially life-threatening complication of COVID-19 that requires prompt recognition and treatment to prevent further complications such as bowel ischemia and perforation. We hereby present a case report of a patient with COVID-19 pneumonia developing ACPO and discuss the suggested pathophysiology, diagnostic approach, and treatment options.
冠状病毒病（COVID-19）主要是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的一种呼吸道疾病。然而，已知该疾病还会引发一系列肺外表现，包括胃肠道（GI）症状，如恶心、呕吐和腹泻。病毒导致肺外表现的确切机制尚未完全明确，但据推测，病毒可通过血管紧张素转换酶2（ACE2）受体进入包括胃肠道在内的其他器官的细胞。这可能导致受影响器官发生炎症和损伤。在极少数情况下，COVID-19还可引起急性结肠假性梗阻（ACPO），这是一种以肠梗阻症状为特征但不存在物理梗阻的病症。急性结肠假性梗阻是COVID-19的一种严重且可能危及生命的并发症，需要及时识别和治疗，以预防诸如肠缺血和穿孔等进一步并发症。我们在此报告一例COVID-19肺炎患者并发ACPO的病例，并讨论所建议的病理生理学、诊断方法和治疗选择。
