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Review
. 2022 Mar 25;16(1):135.
doi: 10.1186/s13256-022-03276-z.

Acute right-sided ischemic colitis in a COVID-19 patient: a case report and review of the literature

Hefzi Alratrout  1 , Eric Debroux  2
Affiliations
Review

Acute right-sided ischemic colitis in a COVID-19 patient: a case report and review of the literature

Hefzi Alratrout et al. J Med Case Rep. .

Abstract

Introduction: In addition to attacking the respiratory system, the coronavirus disease may attack the gastrointestinal tract in various ways, one of which is by creating a coagulopathy that may lead to acute ischemia of the bowel, increasing morbidity and mortality rates in these patients.

Presentation of case: We present a case of a white 72-year-old European male, who was admitted to the intensive care unit after developing COVID-19-induced acute respiratory distress syndrome. On the third week, despite a favorable evolution of his respiratory symptoms, the patient became clinically septic; laboratory findings showed an augmentation of his D-dimer, fibrinogen, C-reactive protein, and procalcitonin levels. Imaging showed signs of ischemia of the right colon. The patient was taken to the operating room; only the right side of his colon was ischemic, with a well demarcated cut-off. A laparoscopic right hemicolectomy with a terminal ileostomy was performed. The patient was able to go home 2 weeks after surgery.

Discussion and conclusion: Ischemic colitis is an uncommon pathology in the general population, and is rare in COVID-19 patients. Most cases of ischemic colitis in COVID-19 patients in the literature were limited to the left colon, with < 10 cases involving the right colon. Accurate and quick diagnosis with appropriate management is the key to avoid any mortality in those patients who are already weakened by the coronavirus.

Keywords: COVID-19; Case report; Right-sided ischemic colitis.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Abdominal X-ray showing pneumatosis intestinalis in the right colon (arrows)
Fig. 2
Fig. 2
Abdominal computerized tomography (CT) scan with pneumatosis intestinalis of the right colon (arrows) (soft tissue window)
Fig. 3
Fig. 3
Abdominal computerized tomography (CT) scan with pneumatosis intestinalis of the right colon (arrows) (lung window)
Fig. 4
Fig. 4
Gross specimen showing a well-demarcated ischemia of the right colon
See this image and copyright information in PMC

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