Case Report: Paralytic Ileus: A Potential Extrapulmonary Manifestation of Severe COVID-19.
Am J Trop Med Hyg
; 103(4): 1600-1603, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-740526
ABSTRACT
The COVID-19 pandemic has recently spread worldwide, presenting primarily in the form of pneumonia or other respiratory disease. In addition, gastrointestinal manifestations have increasingly been reported as one of the extrapulmonary features of the virus. We report two cases of SARS-CoV-2 infection complicated by paralytic ileus. The first patient was a 33-year-old man who was hospitalized with severe COVID-19 pneumonia requiring ventilator support and intensive care. He developed large bowel dilatation and perforation of the mid-transverse colon, and underwent laparotomy and colonic resection. Histopathology of the resected bowel specimen showed acute inflammation, necrosis, and hemorrhage, supporting a role for COVID-19-induced micro-thrombosis leading to perforation. The second patient was a 33-year-old man who had severe COVID-19 pneumonia, renal failure, and acute pancreatitis. His hospital course was complicated with paralytic ileus, and he improved with conservative management. Both cases were observed to have elevated liver transaminases, which is consistent with other studies. Several authors have postulated that the angiotensin-converting enzyme 2 receptors, the host receptors for COVID-19, that are present on enterocytes in both the small and large bowel might mediate viral entry and resultant inflammation. This is a potential mechanism of paralytic ileus in cases of severe COVID-19 infection. Recognizing paralytic ileus as a possible complication necessitates timely diagnosis and management.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pancreatitis
/
Pneumonia, Viral
/
Intestinal Pseudo-Obstruction
/
Coronavirus Infections
/
Renal Insufficiency
/
Betacoronavirus
/
Intestinal Perforation
Type of study:
Case report
/
Prognostic study
Language:
English
Journal:
Am J Trop Med Hyg
Year:
2020
Document Type:
Article
Affiliation country:
Ajtmh.20-0894
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