Superior Mesenteric Artery Thrombosis in COVID-19-Positive Patients: A Rare Coincidence

TL;DR

This paper examines rare cases of superior mesenteric artery thrombosis in patients with COVID-19 and highlights the need for early diagnosis and treatment.

Contribution

The study presents a case series of SMA thrombosis in post-COVID-19 patients and emphasizes the challenges in managing this condition.

Findings

Five patients with SMA thrombosis post-COVID-19 were treated surgically with varying outcomes.

Bowel resection and anastomosis were performed in three patients, while two required stoma placement.

The study highlights the high mortality risk of acute mesenteric ischemia in these patients.

Abstract

Since the start of the SARS-CoV-2 pandemic, which is otherwise known as the worldwide coronavirus disease, 2019, has had a well-established pro-thrombotic character. Patients often first exhibit respiratory symptoms, and those whose severity increases eventually develop acute hypoxic respiratory failure. The systemic hypercoagulable condition and arterial/venous thrombosis related to COVID-19 have a poor prognosis. Even though superior mesenteric artery (SMA) thrombosis and acute mesenteric ischemia (AMI) are uncommon, they frequently coexist with fatal gastrointestinal (GI) pathologies that necessitate prompt diagnosis and treatment by the doctor. This calls for more research into the effects of anticoagulation therapy in COVID-19-positive patients. The main treatment aims for this condition are early detection, surgical or intravascular re-establishment of blood supply to the ischemic bowel, and surgical resection. The study aimed to see the outcome after surgical intervention in patients with SMA thrombosis post-COVID-19 infection. This study was from March 2021 to January 2022, with a sample size of 5 patients with SMA thrombosis, which was confirmed on contrast-enhanced computed tomography (CECT) abdomen and pelvis with angiography. The patients underwent exploratory laparotomy. Bowel resection and anastomosis were performed in three individuals; bowel resection and stoma placement were performed in two patients. Doctors have significant clinical challenges as a result of the thromboembolic manifestations of the unexpected and deadly nature of the virus, such as AMI. The high morbidity and mortality associated with AMI calls for further study on prophylactic anticoagulation therapy in COVID-19-positive individuals.

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