# Acute Mesenteric Ischemia Mimicking Severe COVID-19 Pneumonia: A Case Report on Diagnostic Challenges and Management

## TL;DR

A case report shows how acute mesenteric ischemia can mimic severe COVID-19 pneumonia, emphasizing the importance of abdominal imaging for accurate diagnosis.

## Contribution

Highlights the diagnostic challenge of acute mesenteric ischemia presenting as severe COVID-19 pneumonia without typical abdominal symptoms.

## Key findings

- Abdominal CT imaging revealed intramural and portal emphysema, confirming acute mesenteric ischemia in a patient with severe COVID-19 symptoms.
- The case underscores the need for comprehensive evaluation in COVID-19 patients with systemic symptoms to detect coexisting serious conditions.
- Early detection through imaging is crucial for appropriate management and better outcomes in such complex cases.

## Abstract

This article demonstrates the need for abdominal imaging in COVID-19 patients with systemic symptoms in the differential diagnosis of acute mesenteric ischemia and critical COVID-19 pneumonia. We detail the case of a 91-year-old man, initially diagnosed with severe COVID-19 pneumonia, who was later found to have acute mesenteric ischemia through abdominal CT imaging, despite lacking typical abdominal symptoms. Abdominal CT revealed intramural and portal emphysema, leading to a diagnosis of acute mesenteric ischemia. Given the patient's advanced age and poor condition, supportive care was chosen, with the patient passing away 12 hours post-admission. This case highlights the critical need for comprehensive evaluation, including abdominal imaging, in COVID-19 patients with systemic symptoms to identify other serious conditions like acute mesenteric ischemia, especially in the absence of specific abdominal pain. Early detection is vital for appropriate management and improved patient outcomes.