TABLE 3.
Management strategies for bowel ischaemia secondary to COVID‐19
| Author | Year | Type | Purpose of study | Place of study | Conclusion |
|---|---|---|---|---|---|
| Cheung S et al 33 | 2020 | Case reports | COVID‐19‐induced thrombosis of the superior mesenteric artery. | USA | This case was managed with exploratory laparotomy, thrombectomy and resection of the ischaemic bowel |
| Krothapalli N et al 39 | 2021 | Case report and literature review | Discusses aetiology, clinical picture and laboratory findings of mesenteric ischaemia in COVID‐19‐positive patients and explains a case of it | USA | Surgical resection of the bowel is aided with gastric decompression and fluid resuscitation. This complication is best prevented by prophylactic thrombolytics |
| Bannazadeh M et al 40 | 2021 | Case report | Case report discussing the presentation of mesenteric artery thrombosis in a patient with COVID‐19, 1 week after discharge | USA | Therapeutic enoxaparin for 3 months following bowel resection and end‐to‐end anastomosis will help |
| Alharthy A et al 41 | 2020 | Case report | To examine a case of COVID‐19 presenting with acute abdomen and sepsis. | Saudi Arabia | Management mainly involves exploratory laparotomy, resection of the ischaemic area and anticoagulation in the post‐op period. Based on renal function, enoxaparin is recommended for therapeutic anticoagulation |
| Kariyawasam JC et al 42 | 2021 | Review article | Presents the gastrointestinal manifestations of COVID‐19 | Sri Lanka | Cases of acute abdomen and GI bleeding may warrant surgical or endoscopic modalities for management |
| Tang N et al 43 | 2020 | Retrospective cohort study | To study the efficacy of low molecular weight heparin in decreasing the risk of disseminated intravascular coagulation and venous thromboembolism | China | Low molecular weight heparin appears to be the mainstay for therapeutic anticoagulation in severe COVID‐19 patients with elevated d‐dimer |
| Dinoto E et al 44 | 2021 | Case report | Introduces a case of mesenteric ischaemia which was followed by acute limb ischaemia in a patient with COVID‐19 | Italy | Endovascular management can be used as it has reduced mortality and morbidity rates. Different options exist such as mechanical thrombectomy, local thrombolysis and PTA stenting |
| Balani P et al 45 | 2021 | Case Report and literature review | Discusses early detection and management of bowel ischaemia in a patient with COVID‐19 | India | Catheter‐directed thrombolysis with thrombus aspiration is a possible treatment modality for superior mesenteric thrombus if caught early |
| Mariette X et al 46 | 2021 | Research Letter | Follow‐up article to a trial of tocilizumab in hospitalised patients of COVID‐19 infection | France | Treatment of moderate‐to‐severe COVID‐19 with elevated CRP levels can include the use of tocilizumab |
| Shaikh DH et al 47 | 2021 | Case report and literature review | To explain a case of COVID‐19‐related colitis along with distention and ischaemia | USA | Tocilizumab infusion can also be added after bowel resection to the management to treat COVID‐19 |