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. 2020 Nov 2;40(7):1866–1892. doi: 10.1148/rg.2020200195

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2020 by the Radiological Society of North America, Inc.

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

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Ischemic enterocolitis, periportal edema, mesenteric congestion, ascites, and multifocal bilateral native and renal transplant infarcts in a severely ill 75-year-old man with COVID-19 pneumonia, elevated liver function test results, and oliguria. (a, b) Coronal (a) and axial (b) contrast-enhanced images of the abdomen and pelvis show marked pericholecystic and periportal edema (white arrows) and thickened small and large bowel (black arrows). Note that the colon is fluid filled. Multifocal wedge-shaped areas of hypoattenuation are depicted in the renal cortex of the transplant kidney allograft and native kidneys (arrowheads), compatible with multifocal native renal and renal transplant infarcts. Note the marked heterogeneity of the liver parenchyma that could be attributable to hepatitis (* in a). The main mesenteric vasculature was patent. Mesenteric congestion and ascites were also present, implying the manifestation of mesenteric ischemia, likely as a result of microthrombosis. (c) Endoscopic image of the left colon shows denudation of the colonic epithelium, compatible with ischemic colitis. (Case courtesy of Christine [Cooky] Menias, MD, Mayo Clinic, Phoenix, Ariz.) — Ischemic enterocolitis, periportal edema, mesenteric congestion, ascites, and multifocal bilateral native and renal transplant infarcts in a severely ill 75-year-old man with COVID-19 pneumonia, elevated liver function test results, and oliguria. (a, b) Coronal (a) and axial (b) contrast-enhanced images of the abdomen and pelvis show marked pericholecystic and periportal edema (white arrows) and thickened small and large bowel (black arrows). Note that the colon is fluid filled. Multifocal wedge-shaped areas of hypoattenuation are depicted in the renal cortex of the transplant kidney allograft and native kidneys (arrowheads), compatible with multifocal native renal and renal transplant infarcts. Note the marked heterogeneity of the liver parenchyma that could be attributable to hepatitis (* in a). The main mesenteric vasculature was patent. Mesenteric congestion and ascites were also present, implying the manifestation of mesenteric ischemia, likely as a result of microthrombosis. (c) Endoscopic image of the left colon shows denudation of the colonic epithelium, compatible with ischemic colitis. (Case courtesy of Christine [Cooky] Menias, MD, Mayo Clinic, Phoenix, Ariz.)