ОСТРЫЕ ИШЕМИЧЕСКИЕ ПОРАЖЕНИЯ КИШЕЧНИКА НА ФОНЕ НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ

Abstract

Purpose of the study. Acute ischemic intestinal (AII) lesions developed against the background of a new coronavirus infection. Materials and methods. The study included 23 patients with AII. The mean age of the patients was 59.9±15.0 with male predominance (17 males, 73.91% versus 6 females, 26.09%). The diagnosis of all patients: a new coronavirus infection caused by SARS-CoV-2 was confirmed by the results of PCR tests (polymerase chain reaction). All patients underwent computed tomography of the abdominal organs (CT of the abdominal cavity). The diagnostic algorithm was contrast-enhanced computed tomography, which is considered a valuable instrumental method of investigation in patients with COVID-19 with suspected AII. Statistical processing of the results of the study was carried out using the program STATISTICA. Results. It was confirmed that ischemia of the small intestine is the most common case in surgical examination, resection of the necrotic part of the small intestine with the formation of anastomosis was the most common surgical procedure in 14 (60.85%) patients, resections of the large intestine were performed in 7 (30.45%) patients, and only 2 (8.7%) patients underwent open thrombectomy. Histopathological examination was performed in 21 patients (91.30%) and revealed general features including necrosis, ulcer, hemorrhage in 11 patients (47.82%), neutrophilic infiltration in 7 patients (30.4%) or abscess in 3 patients (13.04%). Following the dynamics of changes in blood biomarkers in patients included in this study, we can conclude that there were such changes in biomarkers as a persistent increase in blood biomarkers evaluated in this study, such as D-dimer, LDH, ferritin and IL-6. Conclusion. Because of the high mortality rate in GI ischemia, clinicians should always be alert for ischemia to prevent its progression and promptly treat any complications. If patients have clinical signs of peritonitis, regardless of the presence of concomitant pathology, an immediate operation should be performed to eliminate the source of infection in the abdominal cavity. Changes in biomarkers and elevated levels of CRP (C-reactive protein), lactate, and D-dimer may be of low predictive value as possible prognostic factors because they may be found in severe COVID-19 infection.