Monocentric case-series of mesenteric vascular disease occurred in the first month of the COVID-19 pandemic

Daniela Di Lella; Giuseppe Petrone; Eugenio Martelli; Rossella Chiara Vigliotti; Gennaro Vigliotti

doi:10.1016/j.avsurg.2021.100004

Monocentric case-series of mesenteric vascular disease occurred in the first month of the COVID-19 pandemic

Ann Vasc Surg Brief Rep Innov. 2021 Sep;1(1):100004. doi: 10.1016/j.avsurg.2021.100004. Epub 2021 Oct 11.

Authors

Daniela Di Lella¹, Giuseppe Petrone¹, Eugenio Martelli^{2

3}, Rossella Chiara Vigliotti⁴, Gennaro Vigliotti¹

Affiliations

¹ Division of Vascular Surgery, Del Mare Hospital, Via Enrico Russo, 80147 Naples, Italy.
² Division of Vascular Surgery, Department of Cardiovascular Sciences, S. Anna and S. Sebastiano Hospital, Caserta, Italy. Saint Camillus International University of Health Sciences, Rome, Italy.
³ Department of General and Specialist Surgery "Paride Stefanini", Sapienza University of Rome, Rome, Italy.
⁴ Residency Program in Vascular Surgery, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.

Abstract

Objectives: we describe Coronavirus Disease (COVID-19) patients also manifesting gastro-intestinal symptoms.

Methods: five women, between the ages of 32 and 82 years old, were admitted for acute abdomen, and received a nasopharyngeal swab for COVID-19 screening, lab test analysis, and contrast thoraco-abdominal CT-scan. All presented leukocytosis, different localizations of visceral vessels thrombosis and ischemia, and COVID-19.

Results: emergency laparotomy was accepted by all but 1, who died after 5 days. Postoperatively, 1 died of multi-organ failure, 3 were discharged home after 14, 8 and 10 days respectively, under anti-platelet and anticoagulation treatment.

Conclusions: in COVID-19 patients with acute abdomen, abdominal contrast CT-scans should be systematically extended to the thorax to detect visceral COVID-19 initial pulmonary signs. Emergency laparotomy and visceral arteries thrombectomy could be necessary.

Keywords: CoViD -19; Hypercoagulability; SARS-CoV-2; Visceral ischemia; Visceral thrombosis.