Kim Minju, Han Jeong Hee, Choi Jung Bum, Lee Byoung Chul, Jung Hyuk Jae
Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
Front Surg. 2024 Aug 21;11:1394638. doi: 10.3389/fsurg.2024.1394638. eCollection 2024.
Arteritis refers to all infectious and non-infectious conditions that lead to inflammation of the arterial wall. However, little is known about its presence in patients with coronavirus disease 2019 (COVID-19). Most patients improved with steroids along with conservative treatments in a few studies. We report our experience with superior mesenteric artery (SMA) arteritis causing an aneurysm following COVID-19 infection.
A 66-year-old female patient who was infected with COVID-19 1 month prior presented with abdominal pain. A computed tomography scan revealed proximal SMA arteritis. Although preliminary antibacterial treatment was initiated, the follow-up CT revealed an aggressive and fast-growing 5.7-cm SMA aneurysm. Subsequently, an open interposition bypass of the SMA aneurysm was performed successfully. As the specimens retrieved during surgery showed no bacterial colonization in the tissue or blood cultures, the patient was discharged without complications.
The mechanism of arteritis in patients with COVID-19 has not been elucidated. In the absence of evidence of bacterial infection in arteritis, it is necessary to consider the possibility of viral infection caused by COVID-19 during the COVID-19 pandemic era and start with high-dose steroid therapy promptly.
动脉炎是指所有导致动脉壁炎症的感染性和非感染性病症。然而，关于其在2019冠状病毒病（COVID-19）患者中的存在情况知之甚少。在一些研究中，大多数患者使用类固醇药物并结合保守治疗后病情有所改善。我们报告了1例COVID-19感染后发生肠系膜上动脉（SMA）动脉炎并导致动脉瘤的病例。
1例66岁女性患者，1个月前感染COVID-19，出现腹痛。计算机断层扫描显示近端SMA动脉炎。尽管开始了初步的抗菌治疗，但后续CT显示有一个5.7厘米的SMA动脉瘤，生长迅速且具有侵袭性。随后，成功进行了SMA动脉瘤的开放搭桥手术。由于手术中获取的标本在组织或血培养中均未显示细菌定植，患者出院时无并发症。
COVID-19患者动脉炎的发病机制尚未阐明。在动脉炎无细菌感染证据的情况下，在COVID-19大流行期间有必要考虑COVID-19病毒感染的可能性，并及时开始大剂量类固醇治疗。
