Mesenteric ischemia in patients with COVID-19: an updated systematic review of abdominal CT findings in 75 patients
| Autor: | Aprateem Mukherjee, Priya Jagia, Avinash Mani, Vineeta Ojha, Sanjeev Kumar |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Hollow Organ GI Ischemic colitis Ischemia Laparotomy Internal medicine Abdomen Humans Medicine Radiology Nuclear Medicine and imaging Vein Radiological and Ultrasound Technology business.industry Gastroenterology COVID-19 Hepatology medicine.disease Mesenteric ischemia medicine.anatomical_structure Small bowel ischemia Histopathology Radiology Tomography X-Ray Computed business Complication Artery |
| Zdroj: | Abdominal Radiology (New York) |
| ISSN: | 2366-0058 |
| DOI: | 10.1007/s00261-021-03337-9 |
| Popis: | Background Acute mesenteric ischemia (AMI) is a less common but devastating complication of COVID-19 disease. The aim of this systematic review was to assess the most common CT imaging features of AMI in COVID-19 and also provide an updated review of the literature on symptoms, treatment, histopathological and operative findings, and follow-up of these patients. Methods A systematic literature search of four databases: Pubmed, EMBASE, WHO database, and Google Scholar, was performed to identify all the articles which described abdominal CT imaging findings of AMI in COVID-19. Results A total of 47 studies comprising 75 patients were included in the final review. Small bowel ischemia (46.67%) was the most prevalent abdominal CT finding, followed by ischemic colitis (37.3%). Non-occlusive mesenteric ischemia (NOMI; 67.9%) indicating microvascular involvement was the most common pattern of bowel involvement. Bowel wall thickening/edema (50.9%) was more common than bowel hypoperfusion (20.7%). While ileum and colon both were equally involved bowel segments (32.07% each), SMA (24.9%), SMV (14.3%), and the spleen (12.5%) were the most commonly involved artery, vein, and solid organ, respectively. 50% of the patients receiving conservative/medical management died, highlighting high mortality without surgery. Findings on laparotomy and histopathology corroborated strikingly with CT imaging findings. Conclusion In COVID-19 patients with AMI, small bowel ischemia is the most prevalent imaging diagnosis and NOMI is the most common pattern of bowel involvement. Contrast-enhanced CT is a powerful decision-making tool for prompt diagnosis of AMI in COVID-19, thereby potentially improving time to treat as well as clinical outcomes. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s00261-021-03337-9. |
| Databáze: | OpenAIRE |
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