A 29-Year-Old Male Construction Worker from India Who Presented with Left- Sided Abdominal Pain Due to Isolated Superior Mesenteric Vein Thrombosis Associated with SARS-CoV-2 Infection

Am J Case Rep. 2020 Sep 24:21:e926785. doi: 10.12659/AJCR.926785.

Abstract

BACKGROUND In corona virus disease 2019 (COVID-19), which emerged in December 2019 and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most case presentations have been related to the respiratory tract. Several recent studies reveal that angiotensin-converting enzyme 2 (ACE2), which was found in the target cells of the virus, is highly expressed in the lungs, small bowel, and vasculature. CASE REPORT A 29-year-old male construction worker from India presented with left-sided colicky abdominal pain. He tested positive for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription-polymerase chain reaction (RT-PCR). Isolated superior mesenteric vein thrombosis was diagnosed by CT (computed tomography) scan. He was managed by anti-coagulants and clinically improved. CONCLUSIONS This case report indicates that isolated venous thrombosis of the abdominal vessels without concurrent arterial thrombosis can be a complication of the hyper-coagulability state in COVID-19 patients. Hence, early evaluation of abdominal vessels in covid-19 patients who present with any abdominal symptoms should be considered, especially when found to have an elevated D-dimer level, as early treatment of thrombosis with low-molecular-weight heparin can have a significant impact on the therapeutic outcome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Adult
  • Anticoagulants / administration & dosage*
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / methods
  • Construction Industry
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Humans
  • India
  • Male
  • Mesenteric Vascular Occlusion / diagnostic imaging*
  • Mesenteric Vascular Occlusion / drug therapy
  • Mesenteric Vascular Occlusion / virology
  • Mesenteric Veins
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Radiography, Thoracic / methods
  • Real-Time Polymerase Chain Reaction / methods
  • Risk Assessment
  • Severity of Illness Index
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnostic imaging*
  • Venous Thrombosis / drug therapy*

Substances

  • Anticoagulants