Omental Necrosis and Mesenteric Ischemia Secondary to Hypercoagulability Due to COVID-19: A Case Report

Authors

  • Diego Guacaneme, MD Simon Bolivar Hospital of third level, Bogota, Columbia https://orcid.org/0000-0002-2329-5994
  • Edgar F Aguirre, MD Simon Bolivar Hospital of third level, Bogota, Columbia
  • Efrain J. Isaac, MD Simon Bolivar Hospital of third level, Bogota, Columbia
  • Eric E. Vinck, MD Simon Bolivar Hospital of third level, Bogota, Columbia
  • Luis F. Cabrera, MD Fundación cardioinfantil, Bogota, Columbia
  • Diego Salcedo, MD Simon Bolivar Hospital of third level, Bogota, Columbia
  • Jonathan Cardoso, MD Simon Bolivar Hospital of third level, Bogota, Columbia
  • Daniela Gonzalez, MD Simon Bolivar Hospital of third level, Bogota, Columbia

DOI:

https://doi.org/10.38179/ijcr.v3i1.89

Keywords:

Necrosis, Omentum, COVID-19, Hypercoagulability, Case Report

Abstract

Background: Omentum necrosis is a rare cause of acute abdomen. Its main etiologies are torsion on its axis, hypercoagulability, and intra-abdominal infections. Its clinical diagnosis is difficult since its symptoms resemble other abdominal pathologies, so diagnostic confirmation when the pain is present in the right abdomen, which occurs most frequently, is usually intraoperative Surgical treatment is more effective than conservative management in reducing hospital stays and does not require follow-up.

Case Report: We present the case of a 45-year-old male suspected to be infected with SARS-CoV-2, which potentially triggered hypercoagulability with necrosis of the greater omentum and mesenteric ischemia, requiring multiple surgical interventions.

Conclusion: It is a rare cause of acute abdomen and to the best of our knowledge, the description of the first case of necrosis of the omentum secondary to COVID-19.

References

Eitel GG. Rare Omental Torsion. New York Med Rec.1899;55:715.

Medina-Gallardo NA, Curbelo-Peña Y, Stickar T, et al. OMENTAL INFARCTION: SURGICAL or CONSERVATIVE TREATMENT? A CASE REPORTS and CASE SERIES SYSTEMATIC REVIEW. Ann Med Surg (Lond). 2020;56:186-193.

PMID:32642061. https://doi.org/10.1016/j.amsu.2020.06.031

Breunung N, Strauss P. A diagnostic challenge: primary omental torsion and literature review - a case report. World J Emerg Surg. 2009;4:40. PMID: 19922627. https://doi.org/10.1186/1749-7922-4-40

Zaleta-Cruz JL, Rojas-Méndez J, Garza-Serna U, González-Ruvalcaba R, de Elguea-Lizarraga JO, Flores-Villalba E. Torsión de epiplón. Reporte de caso. Cirugía y Cirujanos, 2017;85(1):49-53. https://doi.org/10.1016/j.circir.2015.08.008.

Ng LF, Hibberd ML, Ooi EE, et al. A human in vitro model system for investigating genome-wide host responses to SARS coronavirus infection. BMC Infect Dis. 2004;4:34. Published 2004 Sep 9. PMID: 15357874. https://doi.org/10.1186/1471-2334-4-34

Chowdhury JF. Moores LK, Connors, JM. Anticoagulation in Hospitalized Patients with Covid-19.. NEJM. 2020; 383:1675-1678. New England Journal of Medicine October 22, 2020 383(17):1675. https://doi.org/10.1056/NEJMclde2028217

Shi C, Tingting W, Li JP, et al. Comprehensive Landscape of Heparin Therapy for COVID-19. Carbohydr Polym. 2021;254:117232. PMID: 33357843. https://doi.org/10.1016/j.carbpol.2020.117232

Vivas D, Roldán V, Esteve-Pastor MA, et al. Recomendaciones sobre el tratamiento antitrombótico durante la pandemia COVID-19. Posicionamiento del Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología [Recommendations on antithrombotic treatment during the COVID-19 pandemic. Position statement of the Working Group on Cardiovascular Thrombosis of the Spanish Society of Cardiology]. Rev Esp Cardiol. 2020;73(9):749-757. PMID: 32327870. https://doi.org/10.1016%2Fj.recesp.2020.04.006

Drago F, Gozzo L, Li L, Stella A, Cosmi B. Use of Enoxaparin to Counteract COVID-19 Infection and Reduce Thromboembolic Venous Complications: A Review of the Current Evidence. Front Pharmacol. 2020;11:579886. PMID: 33041824. https://doi.org/10.3389/fphar.2020.579886

Nadeem R, Thomas SJ, Fathima Z, et al. Pattern of anticoagulation prescription for patients with Covid-19 acute respiratory distress syndrome admitted to ICU. Does it impact outcome?. Heart Lung. 2021;50(1):1-5. PMID: 33138975. https://doi.org/10.1016/j.hrtlng.2020.10.009

Karcaaltincaba M, Eldem G, Ozdeniz I, Akata D, Ozmen M, Akhan O. Omental vascular pedicle sign: Multidetector CT finding useful for diagnosis of an omental mass. European Journal of Radiology. 2012;81(2):166-169. https://doi.org/10.1016/j.ejrad.2011.01.043. http://www.sciencedirect.com/science/article/pii/S0720048X11000726

Yagnik VD. Primary omental torsion. ANZ J Surg. 2019;89(11):1515-1516. PMID: 30497099. https://doi.org/10.1111/ans.14952

Helms J, Tacquard C, Severac F, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med. 2020;46(6):1089-1098. PMID: 3236717. https://doi.org/10.1007%2Fs00134-020-06062-x

Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-1099. PMID: 32220112. https://doi.org/10.1111/jth.14817

(A), Axial computed tomography of the abdomen in axial section showing omental mass, (B), sagittal section of the tomography where the omental vein is observed reaching what would be the omental mass. (C), coronal section where it is observed that the omental vein drains to the splenic vein.

Published

2023-02-05

How to Cite

Guacaneme, D., Aguirre, E. ., Isaac, E. ., Vink , E. ., Cabrera, L. ., Salcedo, D. ., Cardoso, J., & Gonzalez, D. (2023). Omental Necrosis and Mesenteric Ischemia Secondary to Hypercoagulability Due to COVID-19: A Case Report. International Journal of Clinical Research, 3(1), 233-237. https://doi.org/10.38179/ijcr.v3i1.89

Issue

Vol. 3 No. 1 (2023): Volume 3, Issue 1

Section

Articles

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