A Late Presentation of COVID-19 Induced Bowel Ischemia

Introduction: Infection with COVID-19 may lead to extrapulmonary pathologies secondary to the systemic inflammatory effects of the virus.

Case description: This case report discusses a 55-year-old female patient who presented with small bowel obstruction (SBO) several months after resolution of a COVID-19 infection. The patient was surgically treated with a small bowel resection, and eventually made a full recovery.

Discussion: The pathophysiology of COVID-19-induced SBO can be explained by the prolonged inflammation and coagulation activation in the bowel's vasculature system. Under these circumstances, microthrombosis occurs in the bowel's microvasculature; the affected intestinal tissue becomes ischemic and infarcted. The damaged bowel is eventually replaced with fibrotic scar tissue, thus promoting bowel stricture and subsequent obstruction.

Conclusion: COVID-19 can be responsible for both acute and chronic embolic and thrombotic events in the mesenteric vasculature, which acts as a risk factor in the manifestation of SBO.