AORTIC THROMBOSIS AND ACUTE MESENTERIC ISCHEMIA IN A PATIENT WITH COVID-19 DIAGNOSIS

Abstract

INTRODUCTION: COVID-19, a rapidly spreading infectious disease caused by the Sars-CoV-2 virus, represents a continuous global threat. Among the extrapulmonary disorders associated with COVID-19, arterial and venous thromboembolism has been gaining prominence as one of the most serious consequences and with a very poor prognosis. The thromboembolic events of the arterial macrovasculature described in the literature in association with COVID-19 include thrombosis of the thoracic aorta, infrarenal abdominal aorta, aortoiliac segments and upper mesenteric artery. CASE REPORT: Patient LRCJ, 41 years old, male, with non-insulin-dependent diabetes mellitus and systemic arterial hypertension, he presented positive laboratory tests for the detection of Sars-CoV-2 by the viral PCR method. He reported severe abdominal pain for 1 day, associated with a stop of the elimination of flatus and feces in the same period. Abdominal tomography showed a hypodense thrombus in the distal thoracic aorta and in the superior mesenteric artery. He underwent an exploratory laparotomy with resection of 130 cm of ischemic small intestine. In the postoperative period he evolved with hemodynamic instability, significant clinical deterioration, Acute Renal Insufficiency. He presented with a Cardiorespiratory Arrest on the 16th day of hospitalization, progressing to death. DISCUSSION: Although there is still a need for a more detailed investigation, a possible association between COVID-19 and thrombogenic events seems to be increasingly evident, which makes us more aware of its repercussions in diagnosed patients. Therefore, under COVID-19, assessments of abdominal pain should be thoroughly investigated, and ischemic events should be considered.