Title:A Case of Intestinal Perforation Associated with Mesenteric Thrombosis
Due to Post-COVID-19 Syndrome
Volume: 18
Author(s): Elif Gündoğdu*, Çağatay Cihan, Nevin Aydın, Dilay Demirayak, Ayşegül Özakyol and Mahmut Kebapçı
Affiliation:
- Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
Keywords:
Post-COVID-19 syndrome, mesentery ıschemia, perforation, abscess, CT, thrombosis.
Abstract:
Purpose: We aimed to present a case who developed intestinal ischemia and associated
perforation and abscess due to Superior Mesenteric Vein (SMV) thrombosis caused by post-COVID-19
syndrome and discuss the preoperative Computed Tomography (CT) imaging findings used in diagnosis.
Case Presentation: A 58-year-old patient presented to our clinic with a complaint of acute abdominal
pain. His CT examination revealed thrombosis in SMV, congestion in the mesenteric venous structures,
contamination in the mesentery, and thickening and dilatation of the jejunal loops due to ischemia.
The patient had a history of acute COVID-19 infection. He had typical COVID-19 pneumonia
findings (peripheral ground-glass opacities in both lung parenchyma predominantly in the lower lobe)
on the thorax CT at that time. He was followed up with anticoagulant therapy. During his follow-up, a
thoracic and abdominal CT was performed due to recurrent acute abdominal findings. On thorax CT,
there was a web-like filling defect consistent with pulmonary embolism, traction bronchiectasis consistent
with late findings of COVID-19 pneumonia, and poorly circumscribed subpleural ground glass
opacities. On abdominal CT, in addition to mesenteric ischemia findings, loss of wall integrity was
observed in the jejunal loops due to perforation and collection areas containing air consistent with an
abscess. He was treated with small bowel resection and abscess drainage.
Conclusion: Patients with acute COVID-19 infection should be followed up for the early diagnosis of
serious symptoms that may develop due to post-COVID-19 syndrome, and contrast-enhanced CT
should be the imaging method of choice to detect possible mesenteric vascular thrombosis in patients
with acute abdominal symptoms.
