Analysis of treatment of patients with mesenteric thrombosis complicated by peritonitis in a general surgical hospital

Abstract Introduction The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has provided enormous challenges in the delivery of surgical care. In addition to respiratory tract infections, coronavirus disease 2019 (COVID-19) is associated with both arterial and venous thrombotic complications. Case Details: We present a case of acute superior mesenteric venous (SMV) thrombosis in a 36-year-old female patient who underwent Roux-en-Y gastric bypass three years previously. Her presentation with acute abdominal pain occurred 6 days after a positive nasopharyngeal swab. An admission CT scan demonstrated an abrupt cut off in the proximal SMV with resultant small bowel oedema. Subsequent thrombophilia screening and mutation testing for myeloproliferative neoplasms were all negative. She had also previously carried three pregnancies to term without any thrombotic complications. Hence, the high suspicion of acute COVID-19 induced mesenteric thrombosis. Conclusions In patients who have previously undergone Rouy-en-Y gastric bypass and lost significant weight, acute abdominal pain normally raises a high suspicion of internal hernia. However, as the pandemic progresses surgeons need to be mindful of COVID-19 induced mesenteric thrombosis as a differential diagnosis during the workup of acute abdominal pain. This was well demonstrated on a CT scan with intravenous contrast.

Download Full-text

Mesenteric thrombosis complicated by dermoid cyst

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(45)90145-1 ◽

1945 ◽

Vol 50 (4) ◽

pp. 422-426 ◽

Cited By ~ 1

Author(s):

Ruth Ellis Lesh

Keyword(s):

Dermoid Cyst ◽

Mesenteric Thrombosis

Download Full-text

Mesenteric thrombosis in patient victim of blunt abdominal trauma

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202008000200013 ◽

2008 ◽

Vol 21 (2) ◽

pp. 98-99

Author(s):

Iwan Augusto Collaço ◽

Allan Cezar Diorio ◽

Adonis Nasr ◽

Fernanda Cristina da Silva ◽

William Augusto Casteleins Cecílio ◽

...

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Terminal Ileum ◽

Cardiopulmonary Arrest ◽

Primary Anastomosis ◽

Electric Activity ◽

Right Colon ◽

Gastric Stasis ◽

Car Accident ◽

Mesenteric Thrombosis

INTRODUCTION: Mesenteric thrombosis related to trauma is an uncommon entity and has poor prognosis when associated to low perfusion and hemorrhagic shock. Usually presents a challenging diagnosis and high mortality rates, despite appropriate treatment. OBJECTIVE: To relate a case of a car accident and blunt abdominal trauma with terminal ileum and right colon necrosis. CASE REPORT: After initial procedures, complementary exams showed ribs and humerus fractures. Computerized tomography evidenced aerial distension in small bowel, gastric stasis and hidro-pneumothorax. Hypotension was observed during clinical observation followed by cardiopulmonary arrest, responding to reanimation. At surgery, it was found extensive necrosis of right colon and terminal ileum, and an ileum-transversostomy was performed with primary anastomosis. During the staying in intensive care unit, oliguria, miosis, convulsion and pulseless electric activity happened with death in three days after hospital admission. CONCLUSION: Although uncommon, mesenteric ischemia with venous thrombosis might be secondary to blunt abdominal trauma and must be considered in a bad abdominal evolution.

Download Full-text