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Case report
Superior mesenteric vein and portal vein thrombosis in a patient with COVID-19: a rare case
  1. Milad Jeilani,
  2. Robert Hill,
  3. Mahmud Riad and
  4. Yasser Abdulaal
  1. General Surgery Department, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
  1. Correspondence to Dr Milad Jeilani; milad.jeilani{at}nhs.net

Abstract

A 68-year-old man was referred to the general surgeons on account of his abdominal pain of unknown cause. He had contracted COVID-19, 9 days prior. CT chest abdomen and pelvis revealed an extensive thrombus extending from the portal vein to the superior mesenteric vein. Further investigation ruled out haematological causes, and COVID-19 was determined to be the cause. He was treated with an extended course of therapeutic dose low molecular weight heparin under the guidance of the haematology team. He was discharged once he was clinically stable and pain-free, with a plan to be followed up by both the surgeons and haematologists. This case highlights the different ways in which COVID-19 presents, and the need for clearer guidance on the treatment and prevention of thromboembolism in COVID-19.

  • COVID-19
  • haematology (incl blood transfusion)
  • radiology
  • general surgery
  • portal vein

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-244049

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    Footnotes

    • Contributors MJ led the project and wrote the main bulk of the case report, including the introduction, case report, results and discussion. RH acquired the data, processed it and designed the tables. He also made significant contributions to the discussion. MR provided useful input on the language of the paper, chose the appropriate images and helped with the data interpretation. YA oversaw the planning of the case report and directed its overall theme, and made edits in accordance to this theme. He also provided direct access to the patient and his imaging and lab results.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.