Acute portal vein thrombosis secondary to COVID-19: a case report
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CASE REPORT
Acute portal vein thrombosis secondary to COVID‑19: a case report Roham Borazjani1, Seyed Reza Seraj2, Mohammad Javad Fallahi3* and Zhila Rahmanian4
Abstract Background: COVID-19 pneumonia exhibits several extra-pulmonary complications. Case presentation: A 23-year old, asthmatic male with coronavirus pneumonia developed with generalized, acute abdominal pain. Further evaluations revealed a mild ascites and portal vein thrombosis although the patient received proper anticoagulation therapy. Routine lab data regarding the secondary causes of portal vein thrombosis were normal. Conclusion: We speculated that the underlying cause of portal vein thrombosis in our case was coronaviruses. Therefore, clinicians should always consider thrombosis and other hypercoagulable diseases in patients with COVID-19. Keywords: COVID-19, Pneumonia, Portal vein, Thrombosis Background Novel Coronavirus pneumonia was first described as pneumonia of unknown cause in Wuhan, China, at the end of 2019 [1] and rapidly became pandemic. With time, some new extra-pulmonary manifestations of this viral pneumonia were described. Increased incidence of thromboembolic events was frequently reported [2]. Herein, we aim to describe a 26-year-old male with COVID-19 pneumonia and acute Portal Vein Thrombosis (PVT). Case presentation A 26-year-old male, a known case of asthma, was brought to the Emergency Department (ED) in Faghihi hospital, Shiraz, Iran, on 11 April 2020 due to acute-onset dyspnea and a decrease in the level of consciousness since the day of admission. He was admitted with the impression of an acute asthma attack. There was no history of fever, hemoptysis, diarrhea, nausea, vomiting (N/V), lower *Correspondence: [email protected] 3 Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Full list of author information is available at the end of the article
gastrointestinal tract bleeding, incontinence, and stroke signs and symptoms. He had asthma for several years and only used the salbutamol inhaler as needed. His social history was positive for alcohol, cigarette smoking, and occasionally marijuana. We intubated the patient due to severe hypoxia and respiratory distress; blood Oxygen saturation (O2 Sat.) was 60% and 97% before and after intubation, respectively. The initial vital signs included temperature: 36.9 °C, pulse rate: 110/min, respiratory rate: 36/min, and blood pressure: 120/90 mmHg. Generalized wheezing was heard through auscultation. Other physical findings were normal. Brain computed tomography (CT) was normal. Chest CT showed bilateral peripheral and peribronchovascular patchy ground-glass opacities in both lung fields with tree-in-bud appearance (Fig. 1).The tracheal aspirate was positive for real-time polymerase chain reaction (RTPCR) for SARS-COV2. The blood routine tests are summarized in Table 1. Electrocardiography showed sinus tachycardia, and other findings were normal. Urine analysis was positive for marijuana, benzodiazepine, and m
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