An Unusual Presentation of Superior Mesenteric Venous Occlusion in Mild COVID-19

Abstract

SARS-CoV-2, an etiological agent of COVID-19, has been reported to inflict remarkably diverse manifestations in different subjects across the globe. Though patients with COVID-19 predominantly have fever, respiratory and constitutional symptoms, atypical presentations are becoming increasingly evident. COVID-19 may predispose to both venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilization, and diffuse intravascular coagulation in moderate to severe symptomatic cases. In this case report, we are reporting thromboembolic complications of COVID-19 in a mild symptomatic subject incidentally diagnosed with mesenteric venous occlusion with no abdominal symptoms. Early recognition of the abdominal symptoms, diagnosis, initiation of anticoagulants, and timely surgical intervention may improvise the outcome in a patient with COVID-19 infection-induced mesenteric thrombosis. Superior mesenteric artery and venous thrombosis may lead to subsequent ischemia necessitating emergency laparotomy. Thus, the usage of low-dose anticoagulants in all the patients of COVID-19 irrespective of the categorization into mild, moderate, and severe COVID-19 disease should be considered.

Keywords: COVID-19; Pulmonary embolism; SARS-CoV-2; Thromboembolism; Thrombosis.

Fig. 1

Inhomogenous ground glass opacities with reticular stranding noted in bilateral lungs predominantly in the bilateral lower lobes with areas of patchy consolidation

Fig. 2

CT findings reveal evidence of chronic occlusion of the Superior Mesenteric Vein with the formation of a large tortuous collateral and partial volvulus of the small bowel loops, and diffuse fatty infiltration of the liver