AB182. SOH21AS207. Jejunal ischemia secondary to COVID-19 in an Irish male: case report

Background: Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly transmittable virus that has recently emerged in Wuhan, China before rapidly spreading worldwide. Due to the lack of prior immunity, COVID-19 pandemic has been associated with a high morbidity and mortality worldwide. The main target were the lungs occasionally manifesting as acute respiratory failure. Multiple organ dysfunction was also reported in reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19 patients. Despite ongoing research, information is still significantly lacking.

Methods: In this case report, we will discuss a 74-year-old Irish male who tested RT-PCR covid-19 positive on hospital admission requiring a prolonged rocky intensive care unit (ICU) admission for 2 months due to acute respiratory distress syndrome (ARDS). Whilst in the intensive care unit (ICU), jejunal ischemia was diagnosed both clinically and was confirmed by computerised topography Angiography (CTA). A conservative approach was used in light of the COVID-19 diagnosis, existing comorbidities and ongoing global pandemic. This 74-year-old had a successful recovery and was discharged.

Results: Approximately 3 months later, he presented again to the Accident and emergency department with overwhelming diffuse peritonitis. Emergency laparotomy revealed a perforated jejunum 50 cm from the duodenojejunal flexure. Segmental resection was performed with the formation of a double barrel stoma.

Conclusions: This case report highlights the importance of early recognition of thromboembolic disorders in COVID-19 patients. It also emphasises the crucial role of early operative measures in improving patient’s survival.

Keywords: Coronavirus disease 2019 (COVID-19); case report; acute respiratory distress syndrome (ARDS); jejunal ischemia; thromboembolic events