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. 2021:25:e01205.
doi: 10.1016/j.idcr.2021.e01205. Epub 2021 Jun 24.

Acute colonic pseudo-obstruction in two patients admitted with severe acute respiratory syndrome-coronavirus-2 pneumonia

Stephen Varghese Samuel  1 , Surekha Viggeswarpu  1 , Benny Paul Wilson  1 , Kango Gopal Gopinath  1
Affiliations

Acute colonic pseudo-obstruction in two patients admitted with severe acute respiratory syndrome-coronavirus-2 pneumonia

Stephen Varghese Samuel et al. IDCases. 2021.

Abstract

We have described two cases of severe SARS-CoV-2 pneumonia presenting with acute colonic pseudo-obstruction with normal liver enzymes and serum lactate. These older adults presented predominantly with constitutional symptoms, silent hypoxia, distended abdomen, sluggish bowel sounds, and colonic dilatation supported by abdominal imaging (plain X-ray and computerized tomography of abdomen) to a tertiary care center in South India. Both patients received standard treatment for severe SARS-CoV-2 pneumonia and acute colonic pseudo-obstruction according to available guidelines but succumbed to complications during hospital stay. Acute colonic pseudo-obstruction in patients admitted with SARS-CoV-2 infection requires high index of suspicion as it warrants early mitigation by cessation of offending agents, optimizing electrolytes, and colonic decompression to prevent morbidity and mortality.

Keywords: COVID-19; Colon; Colonic distension; Ogilvie syndrome; Pseudo-obstruction; SARS-CoV-2.

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Conflict of interest statement

The authors report no declarations of interest.

Figures

Fig. 1
Fig. 1
(A) X-ray Abdomen erect showing colonic gaseous distension. (B) Contrast-enhanced Computerized Tomography of Abdomen showing dilated transverse colon, descending colon without obvious mechanical obstruction.
Fig. 2
Fig. 2
X-ray Abdomen erect showing colonic gaseous distension.
See this image and copyright information in PMC

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