ABSTRACT
BACKGROUND: COVID-19 and Fontan physiology have each been associated with an elevated risk of venous thromboembolism (VTE), however little is known about the risks and potential consequences of having both. CASE PRESENTATION: A 51 year old male with tricuspid atresia status post Fontan and extracardiac Glenn shunt, atrial flutter, and sinus sick syndrome presented with phlegmasia cerulea dolens (PCD) of the left lower extremity in spite of supratherapeutic INR in the context of symptomatic COVID-10 pneumonia. He was treated with single session, catheter directed mechanical thrombectomy that was well-tolerated. CONCLUSIONS: This report of acute PCD despite therapeutic anticoagulation with a Vitamin K antagonist, managed with emergent mechanical thrombectomy, calls to attention the importance of altered flow dynamics in COVID positive patients with Fontan circulation that may compound these independent risk factors for developing deep venous thrombosis with the potential for even higher morbidity.
Subject(s)
COVID-19 , Fontan Procedure , Gangrene , Mechanical Thrombolysis , Postoperative Complications , Thrombophlebitis , Tricuspid Atresia , Warfarin/therapeutic use , Amputation, Surgical/methods , Atrial Flutter/drug therapy , Atrial Flutter/etiology , COVID-19/blood , COVID-19/complications , COVID-19/therapy , Fontan Procedure/adverse effects , Fontan Procedure/methods , Gangrene/etiology , Gangrene/surgery , Heart Defects, Congenital/surgery , Humans , Image Processing, Computer-Assisted/methods , Lower Extremity/blood supply , Lower Extremity/pathology , Lower Extremity/surgery , Male , Mechanical Thrombolysis/adverse effects , Mechanical Thrombolysis/methods , Middle Aged , Phlebography/methods , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Postoperative Complications/surgery , Sick Sinus Syndrome/diagnosis , Sick Sinus Syndrome/etiology , Thrombophlebitis/diagnosis , Thrombophlebitis/etiology , Thrombophlebitis/surgery , Tomography, X-Ray Computed/methods , Treatment Outcome , Tricuspid Atresia/etiology , Tricuspid Atresia/surgerySubject(s)
Cervix Uteri/abnormalities , Hematometra/therapy , Intrauterine Devices , Twins, Conjoined , Uterine Cervical Diseases/congenital , Vagina/abnormalities , Vaginal Diseases/congenital , Cervix Uteri/diagnostic imaging , Female , Hematometra/diagnostic imaging , Hematometra/etiology , Humans , Treatment Outcome , Uterine Cervical Diseases/diagnostic imaging , Vagina/diagnostic imaging , Vaginal Diseases/diagnostic imaging , Young AdultSubject(s)
Glomus Tumor/pathology , Stomach/pathology , Female , Humans , Middle Aged , Stomach Neoplasms/pathologyABSTRACT
Foregut duplication cysts are extremely rare congenital malformations. Herein we report a case of 73 year old male with a left upper quadrant abdominal lesion identified on CT scan.
