Superior Mesenteric Arterial and Venous thrombosis in COVID-19

Abstract Background COVID-19 commonly presents with fever, constitutional symptoms, and respiratory symptoms. However atypical presentations are also well known. Though isolated mesenteric arterial occlusion associated with COVID-19 is reported in literature, combined superior mesenteric arterial and venous thrombosis is very rare. We report a case of combined superior mesenteric arterial and venous occlusion associated with COVID-19 infection. Case report We report a case of a 45-year-old male health care worker who presented to the emergency department with severe abdominal pain. Clinical examination was unremarkable but imaging revealed acute mesenteric ischemia due to superior mesenteric artery (SMA) and superior mesenteric vein (SMV) occlusion. The chest imaging was suggestive of COVID-19 infection which was later confirmed with an RT-PCR of his nasopharyngeal swab. To date, only one case of combined SMA and SMV thrombosis due to COVID 19 had been reported Why should an emergency physician be aware of this During the COVID-19 pandemic it is important to keep mesenteric ischemia in the differential diagnosis of unexplained abdominal pain. Routinely adding HRCT of the chest to abdominal imaging should be considered in patients with acute abdomen as it can help to identify COVID-19 immediately.