Open AccessAcute mesenteric ischemia and small bowel imaging findings in COVID-19: A comprehensive review of the literature
Author(s) -
L. Pirola,
Andrea Palermo,
Giacomo Mulinacci,
Laura Ratti,
Maria Fichera,
Pietro Invernizzi,
Chiara Viganò,
Sara Massironi
Publication year - 2021
Publication title -
world journal of gastrointestinal surgery
Language(s) - English
Resource type - Journals
ISSN - 1948-9366
DOI - 10.4240/wjgs.v13.i7.702
Subject(s) - medicine , covid-19 , mesenteric ischemia , ischemia , intestinal ischemia , surgery , radiology , reperfusion injury , pathology , disease , outbreak , infectious disease (medical specialty)
Coronavirus disease 2019 (COVID-19), an infectious condition caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide since its first description in Wuhan in December 2019. Even though respiratory manifestations are the most prevalent and responsible for disease morbidity and mortality, extrapulmonary involvement has progressively gained relevance. In particular, gastrointestinal (GI) signs and symptoms, reported in up to two-thirds of patients with COVID-19, might represent the first and, in some cases, the only disease presentation. Their presence has been associated in some studies with an increased risk of a severe disease course. Proposed pathogenic mechanisms explaining GI tract involvement are either direct viral access to intestinal cells via angiotensin-converting enzyme 2 or indirect damage of the intestinal wall through mesenteric ischemia induced by the hypercoagulable state associated with COVID-19 infection. Although not typical of SARS-CoV-2 infection, several small bowel manifestations have been described in infected patients who underwent any form of abdominal imaging. The radiological findings were mainly reported in patients with abdominal symptoms, among which abdominal pain was the most common.