Ischemic colitis and pneumatosis intestinalis in a patient with COVID-19: a case report
DOI:
https://doi.org/10.24265/horizmed.2021.v21n4.11Keywords:
SARS-CoV-2, Coronavirus infections, Ischemic colitisAbstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus causing the ongoing pandemic. In general, patients infected with SARS-CoV-2 develop respiratory diseases. The first symptoms are fever, cough and dyspnea that rapidly progress to pneumonia. Additionally, extrapulmonary manifestations, such as those in the gastrointestinal system, have been reported. It has been described that the angiotensin-converting enzyme 2 (ACE2) receptor and the transmembrane serine protease 2
(TMPRSS2) for S protein priming favor SARS-CoV-2 entry into the cells. These proteins are expressed in alveolar type II cells as well as in ileum and colon enterocytes, thus detecting the virus in the digestive tract. We present the case of a patient with COVID-19 pneumonia and gastrointestinal findings such as pneumatosis intestinalis and ischemic colitis.
Downloads
References
Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, et al. Digestive system is a potential route of COVID-19: an analysis of single-cell coexpression pattern of key proteins in viral entry process. Gut. 2020; 69(6): 1010-8.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497-506.
Kernagis LY, Levine MS, Jacobs JE. Pneumatosis intestinalis in patientswith ischemia: correlation of CT findings with viability of the bowel. Am J Roentgenol. 2003; 180(3): 733-6.
Doulberis M, Panagopoulos P, Scherz S, Dellaporta E, Kouklakis G. Update on ischemic colitis: from etiopathology to treatment including patients of intensive care unit. Scand J Gastroenterol. 2016; 51(8): 893-902.
Wang F, Wang H, Fan J, Zhang Y, Wang H, Zhao Q. Pancreatic Injury Patterns in Patients with Coronavirus Disease 19 Pneumonia. Gastroenterology. 2020; 159(1): 367-70.
Meini S, Zini C, Passaleva MT, Frullini A, Fusco F, Carpi R, et al. Pneumatosis intestinalis in COVID-19. BMJ Open Gastroenterol. 2020; 7(1): e000434.
He Y, Wen Q, Yao F, Xu D, Huang Y, Wang J. Gut-lung axis: the microbial contributions and clinical implications. Crit Rev Microbiol. 2017; 43(1): 81-95.
Zhao D, Yao F, Wang L, Zheng L, Gao Y, Ye J, et al. A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias. Clin Infect Dis. 2020; ciaa247.
Paul T, Joy AR, Alsoub HARS, Parambil JV. Case report: ischemic colitis in severe COVID-19 pneumonia: an unforeseen gastrointestinal complication. Am J Trop Med Hyg. 2021; 104(1): 63-5.
Morris MS, Gee AC, Cho SD, Limbaugh K, Underwood S, Ham B, et al. Management and outcome of pneumatosis intestinalis. Am J Surg. 2008; 195(5): 679-82.
Pietropaolo MD, Trinci M, Giangregorio C, Galluzzo M, Miele V. Pneumatosis cystoides intestinalis: case report and review of literature. Clin J Gastroenterol. 2020; 13(1): 31-6.
Jenkins M, Courtney H, Pope E, Williamson J. A case report and approach to management in pneumatosis intestinalis. Ann Med Surg (Lond). 2017; 23: 25-7.
Donovan S, Cernigliaro J, Dawson N. Pneumatosis intestinalis: a case report and approach to management. Case Rep Med. 2011; 2011: 571387.
Moya-Sánchez E, Fernández-Navarro L, Medina-Salas V. Enterocolitis neutropénica o tiflitis: causa de abdomen agudo en paciente neutropénico. RAPD Online. 2018; 41(3): 159-61.
Ettayebi K, Crawford SE, Murakami K, Broughman JR, Karandikar U, Tenge VR, et al. Replication of human noroviruses in stem cell-derived human enteroids. Science. 2016; 353(6306): 1387-93.
Wayne E, Ough M, Wu A, Liao J, Andresen KJ, Kuehn D, et al. Management algorithm for pneumatosis intestinalis and portal venous gas: treatment and outcome of 88 consecutive cases. J Gastrointest Surg. 2010; 14(3): 437-48.
Hawn MT, Canon CL, Lockhart ME, Gonzalez QH, Shore G, Bondora A, et al. Serum lactic acid determines the outcomes of CT diagnosis of pneumatosis of the gastrointestinal tract. Am Surg. 2004; 70(1): 19-23.
Rehman M, Gondal A, Khan S, Rehman NU, Molina J. Neutropenic enterocolitis and rapid spontaneous resolution of portal venous gas: a non-respiratory manifestation of COVID-19. Cureus. 2020; 12(7): e9445.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
