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Spontaneous portomesenteric thrombosis in a non-cirrhotic patient with SARS-CoV-2 infection.
BMJ Case Rep. 2020 Dec 22; 13(12)BC

Abstract

Intra-abdominal thromboses are a poorly characterised thrombotic complication of COVID-19 and are illustrated in this case. A 42-year-old man with chronic hepatitis B (undetectable viral load, FibroScan 7.4 kPa) developed fever and cough in March 2020. 14 days later, he developed right upper quadrant pain. After being discharged with reassurance, he re-presented with worsening pain on symptom day 25. Subsequent abdominal ultrasound suggested portal vein thrombosis. CT of the abdomen confirmed portal and mid-superior mesenteric vein thromboses. Concurrent CT of the chest suggested COVID-19 infection. While reverse transcription PCR was negative, subsequent antibody serology was positive. Thrombophilia screen excluded inherited and acquired thrombophilia. Having been commenced on apixaban 5 mg two times per day, he is currently asymptomatic. This is the first case of COVID-19-related portomesenteric thrombosis described in the UK. A recent meta-analysis suggests 9.2% of COVID-19 cases develop abdominal pain. Threshold for performing abdominal imaging must be lower to avoid this reversible complication.

Authors+Show Affiliations

Department of Liver Medicine, Bristol Royal Infirmary, Bristol, UK k.abeysekera@bristol.ac.uk.Department of Radiology, Bristol Royal Infirmary, Bristol, UK.Bristol Haematology and Oncology Centre, Bristol Royal Infirmary, Bristol, UK.Department of Liver Medicine, Bristol Royal Infirmary, Bristol, UK.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

33371000

Citation

Abeysekera, Kushala Wm, et al. "Spontaneous Portomesenteric Thrombosis in a Non-cirrhotic Patient With SARS-CoV-2 Infection." BMJ Case Reports, vol. 13, no. 12, 2020.
Abeysekera KW, Karteszi H, Clark A, et al. Spontaneous portomesenteric thrombosis in a non-cirrhotic patient with SARS-CoV-2 infection. BMJ Case Rep. 2020;13(12).
Abeysekera, K. W., Karteszi, H., Clark, A., & Gordon, F. H. (2020). Spontaneous portomesenteric thrombosis in a non-cirrhotic patient with SARS-CoV-2 infection. BMJ Case Reports, 13(12). https://doi.org/10.1136/bcr-2020-238906
Abeysekera KW, et al. Spontaneous Portomesenteric Thrombosis in a Non-cirrhotic Patient With SARS-CoV-2 Infection. BMJ Case Rep. 2020 Dec 22;13(12) PubMed PMID: 33371000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous portomesenteric thrombosis in a non-cirrhotic patient with SARS-CoV-2 infection. AU - Abeysekera,Kushala Wm, AU - Karteszi,Hedvig, AU - Clark,Amanda, AU - Gordon,Fiona H, Y1 - 2020/12/22/ PY - 2020/12/29/entrez PY - 2020/12/30/pubmed PY - 2021/1/5/medline KW - hepatitis B KW - liver disease KW - portal hypertension KW - radiology JF - BMJ case reports JO - BMJ Case Rep VL - 13 IS - 12 N2 - Intra-abdominal thromboses are a poorly characterised thrombotic complication of COVID-19 and are illustrated in this case. A 42-year-old man with chronic hepatitis B (undetectable viral load, FibroScan 7.4 kPa) developed fever and cough in March 2020. 14 days later, he developed right upper quadrant pain. After being discharged with reassurance, he re-presented with worsening pain on symptom day 25. Subsequent abdominal ultrasound suggested portal vein thrombosis. CT of the abdomen confirmed portal and mid-superior mesenteric vein thromboses. Concurrent CT of the chest suggested COVID-19 infection. While reverse transcription PCR was negative, subsequent antibody serology was positive. Thrombophilia screen excluded inherited and acquired thrombophilia. Having been commenced on apixaban 5 mg two times per day, he is currently asymptomatic. This is the first case of COVID-19-related portomesenteric thrombosis described in the UK. A recent meta-analysis suggests 9.2% of COVID-19 cases develop abdominal pain. Threshold for performing abdominal imaging must be lower to avoid this reversible complication. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/33371000/Spontaneous_portomesenteric_thrombosis_in_a_non-cirrhotic_patient_with_SARS-CoV-2_infection. L2 - https://casereports.bmj.com/lookup/pmidlookup?view=long&pmid=33371000 DB - PRIME DP - Unbound Medicine ER -