Mesenteric thrombosis in patients with coronavirus disease: comprehensive assessment and treatment

Abstract

Acute mesenteric circulatory disorder belongs to the most serious diseases of the abdominal cavity. Being an emer­gency condition, it is associated with high mortality. Coronavirus infection is an anthroponotic disease in the group of acute respiratory infections, is characterized by damage to the upper respiratory tract, severe intoxication, coagu­lopathy and in severe cases - multiple organ failure. The aim of the work was to analyze the results of the surgical treatment of mesenteric vascular thrombosis in patients with COVID-19. We have studied the results of diagnostics and treatment of 13 patients (9 males and 4 females) with acute mesenteric thrombosis and COVID-19. We have analyzed patients’ complaints and the clinical picture of the disease, as well as performed general medical examination (routine blood and urine tests, biochemical parameters, coagulogram), X-ray examination of abdominal and thoracic cavities, computed tomography / angiography of abdominal organs, diagnostic laparoscopy, diagnostic mini-laparotomy and laparotomy. The symptoms of the disease include nausea, vomiting, abdominal pain, diarrhea, fever, cough, shortness of breath and belching. The disease was diagnosed by contrast computed tomography. Four patients developed simultaneous thrombosis – stroke, thrombosis of the portal and mesenteric veins, splenic and renal infarction, thrombosis of the superior mesenteric and portal veins. Six patients have been suffering from underlying health conditions, 7 patients – had none. Ten patients underwent surgery (laparotomy with resection of the nonviable intestine), 3 – received conservative treatment (heparin therapy). Six patients died (4 out of 10 – during surgery and 2 out of 3 – during conservative treatment). Postoperative mortality was 40%.