tetano
Editor, Senior Moderator
Clin Imaging
. 2021 Apr 14;79:12-19.
doi: 10.1016/j.clinimag.2021.04.002. Online ahead of print.
Abdominal Computed Tomography Angiography and Venography in Evaluation of Hemorrhagic and Thrombotic lesions in Hospitalized COVID-19 patients
Mohsen Ahmed Abdelmohsen[SUP] 1 [/SUP], Buthaina M Alkandari[SUP] 2 [/SUP], Ahmed Abdel Khalek Abdel Razek[SUP] 3 [/SUP], Ahmed Mohamed Tobar[SUP] 2 [/SUP], Vikash K Gupta[SUP] 4 [/SUP], Nermeen Elsebaie[SUP] 5 [/SUP]
Affiliations
Abstract
Purpose: To report imaging findings at computed tomography angiography (CTA) and venography (CTV) of the abdomen and pelvis in evaluation of hemorrhagic and thrombotic lesions in hospitalized patients with COVID-19.
Methods: In this retrospective observational study, patients admitted to a single tertiary care center from April 1 to July 20, 2020, who tested positive for SARS-CoV-2 and developed acute abdominal pain or decreasing hemoglobin levels over the course of hospitalization were included. Abdominal CTA/CTV imaging studies performed in these patients were reviewed, and acute hemorrhagic or thromboembolic findings were recorded.
Results: A total of 40 patients (mean age, 59.7 years; 20 men, 20 women) were evaluated. Twenty-five patients (62.5%) required intensive care unit (ICU) admission and 15 patients (37.5%) were treated in the medical ward. Hemorrhagic complications were detected in 19 patients (47.5%), the most common was intramuscular hematoma diagnosed in 17 patients; It involved the iliopsoas compartment unilaterally in 10 patients, bilaterally in 2 patients and the rectus sheath in 5 cases. Pelvic extraperitoneal hemorrhage was found in 3 patients, and mesenteric hematoma in one patient. Thromboembolic events were diagnosed in 8 patients (20%) including; arterial thrombosis (n = 2), venous thrombosis (n = 2), splenic infarct (n = 1), bowel ischemia (n = 1) and multiple sites of thromboembolism (n = 2).
Conclusion: Our study highlights that both hemorrhagic and thromboembolic complications can be seen in hospitalized patients with COVID-19. It is important that radiologists maintain a high index of suspicion for early diagnosis of these complications.
Keywords: Computed tomography angiography; Computed tomography venography; Coronavirus disease 2019.
. 2021 Apr 14;79:12-19.
doi: 10.1016/j.clinimag.2021.04.002. Online ahead of print.
Abdominal Computed Tomography Angiography and Venography in Evaluation of Hemorrhagic and Thrombotic lesions in Hospitalized COVID-19 patients
Mohsen Ahmed Abdelmohsen[SUP] 1 [/SUP], Buthaina M Alkandari[SUP] 2 [/SUP], Ahmed Abdel Khalek Abdel Razek[SUP] 3 [/SUP], Ahmed Mohamed Tobar[SUP] 2 [/SUP], Vikash K Gupta[SUP] 4 [/SUP], Nermeen Elsebaie[SUP] 5 [/SUP]
Affiliations
- PMID: 33865171
- DOI: 10.1016/j.clinimag.2021.04.002
Abstract
Purpose: To report imaging findings at computed tomography angiography (CTA) and venography (CTV) of the abdomen and pelvis in evaluation of hemorrhagic and thrombotic lesions in hospitalized patients with COVID-19.
Methods: In this retrospective observational study, patients admitted to a single tertiary care center from April 1 to July 20, 2020, who tested positive for SARS-CoV-2 and developed acute abdominal pain or decreasing hemoglobin levels over the course of hospitalization were included. Abdominal CTA/CTV imaging studies performed in these patients were reviewed, and acute hemorrhagic or thromboembolic findings were recorded.
Results: A total of 40 patients (mean age, 59.7 years; 20 men, 20 women) were evaluated. Twenty-five patients (62.5%) required intensive care unit (ICU) admission and 15 patients (37.5%) were treated in the medical ward. Hemorrhagic complications were detected in 19 patients (47.5%), the most common was intramuscular hematoma diagnosed in 17 patients; It involved the iliopsoas compartment unilaterally in 10 patients, bilaterally in 2 patients and the rectus sheath in 5 cases. Pelvic extraperitoneal hemorrhage was found in 3 patients, and mesenteric hematoma in one patient. Thromboembolic events were diagnosed in 8 patients (20%) including; arterial thrombosis (n = 2), venous thrombosis (n = 2), splenic infarct (n = 1), bowel ischemia (n = 1) and multiple sites of thromboembolism (n = 2).
Conclusion: Our study highlights that both hemorrhagic and thromboembolic complications can be seen in hospitalized patients with COVID-19. It is important that radiologists maintain a high index of suspicion for early diagnosis of these complications.
Keywords: Computed tomography angiography; Computed tomography venography; Coronavirus disease 2019.