Acute mesenteric ischemia and small bowel imaging findings in COVID-19:A comprehensive review of the literature

作     者：Lorena Pirola Andrea Palermo Giacomo Mulinacci Laura Ratti Maria Fichera Pietro Invernizzi Chiara Viganò Sara Massironi 

作者机构：Division of Gastroenterology and Center for Autoimmune Liver DiseasesDepartment of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological DiseasesSan Gerardo HospitalMonza 20900Italy 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第7期

页      面：702-716页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：COVID-19 SARS-CoV-2 Radiology Small intestine Abdomen 

摘      要：BACKGROUND Coronavirus disease 2019(COVID-19),an infectious condition caused by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),has rapidly spread worldwide since its first description in Wuhan in December *** though respiratory manifestations are the most prevalent and responsible for disease morbidity and mortality,extrapulmonary involvement has progressively gained *** particular,gastrointestinal(GI)signs and symptoms,reported in up to two-thirds of patients with COVID-19,might represent the first and,in some cases,the only disease *** presence has been associated in some studies with an increased risk of a severe disease *** pathogenic mechanisms explaining GI tract involvement are either direct viral access to intestinal cells via angiotensin-converting enzyme 2 or indirect damage of the intestinal wall through mesenteric ischemia induced by the hypercoagulable state associated with COVID-19 *** not typical of SARS-Co V-2 infection,several small bowel manifestations have been described in infected patients who underwent any form of abdominal *** radiological findings were mainly reported in patients with abdominal symptoms,among which abdominal pain was the most *** To discuss small bowel radiological manifestations of SARS-Co V-2 infection in abdominal imaging *** Bibliographical searches were performed in Pub Med,using the following keywords:COVID-19ANDimagingANDgastrointestinalORabdominalORsmall bowel.RESULTS Of 62 patients with described radiologic small bowel alterations,mesenteric ischemia was diagnosed in 31 cases(50%),small bowel wall thickening in 10 cases(16%),pneumatosis in nine cases(15%),intussusception in eight cases(13%),pneumoperitoneum in two cases(3%)and paralytic ileus in two cases(3%).We also reported mesenteric adipose tissue hypertrophy and lymph nodes enlargement in a young *** So far it is difficult to establish whether