COVID-19 and gastrointestinal symptoms: A case report of a M
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COVID-19-associated coagulopathy is recognized to be one of the key drivers of mesenteric vascular thrombosis; however, there is a lack of both radiologic and histologic evidence for large arterial and venous mesenteric vessel thrombosis.

Authors report a case of COVID-19 infection causing mesenteric ischemia diagnosed early and has been treated with Heparin.

A 68-year-old no smoking male patient with no past medical history, presented with epigastric pain and diarrhea since 4 days. In the physical examination, he was febrile at 38.5°C and he had hypogastric tenderness. Blood test showed WBC at 17 660/mL, C-reactive protein at 125 mg/L, and D-Dimers were elevated at 6876 ng/mL.

An abdominal CT scan showed a thickening of the right colon wall and the last 30 cm of the small bowl associated with an obstruction of the terminal segment of the ileo colic artery. There were no other signs of ischemia. Doctors decided to put the patient under medical treatment with unfractionated heparine. On the second day of his stay, he developed a dry cough and the abdominal pain decreased. We performed a laparoscopy on the third day that showed a normal condition of the colon and the small bowl. With the appearance of respiratory signs and the pandemic context, they decided to perform a COVID-19 RT-PCR test to the patient. He tested positive.

Fortunately, the use of protective clothing was mandatory to take any sample, and wearing a mask is compulsory among staff members and patients in our department. That prevented the spread of the infection during this patient stay. He was transferred to a COVID department established during the epidemic. After 1 week of treatment, the patient is asymptomatic with soft abdomen and normal rate of WBC and C-reactive protein.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ccr3.4235?af=R
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