RESUMO
BACKGROUND: There is increasing evidence supporting coronavirus disease 2019 (COVID-19)-related coagulopathy. In the available literature, only 2 cases of superior mesenteric vein thrombosis have been described. METHODS: We present a peculiar case of high-grade small bowel obstruction in a patient with COVID-19 infection. RESULTS: Exploratory laparotomy revealed a congenital adhesion band with associated focal bowel ischemia contributed by superior mesenteric vein thrombosis and positive lupus anticoagulant. CONCLUSIONS: It is important to consider the rare differential of mesenteric vein thrombosis and its related sequelae of mesenteric ischemia in a patient with COVID-19 who presents with abdominal pain.
Assuntos
Dor Abdominal/etiologia , COVID-19/complicações , Anormalidades do Sistema Digestório/complicações , Isquemia Mesentérica/etiologia , Oclusão Vascular Mesentérica/etiologia , Veias Mesentéricas , Adulto , Anticoagulantes/uso terapêutico , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/virologia , Anormalidades do Sistema Digestório/diagnóstico por imagem , Anormalidades do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório , Interações Hospedeiro-Patógeno , Humanos , Inibidor de Coagulação do Lúpus/sangue , Masculino , Isquemia Mesentérica/diagnóstico , Isquemia Mesentérica/cirurgia , Oclusão Vascular Mesentérica/diagnóstico , Oclusão Vascular Mesentérica/cirurgia , Veias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/cirurgia , SARS-CoV-2/patogenicidade , Aderências Teciduais/congênito , Resultado do TratamentoAssuntos
Injúria Renal Aguda/etiologia , Comportamento Alimentar/psicologia , Obstrução da Saída Gástrica/etiologia , Hiperfagia/complicações , Pancreatite/etiologia , Dor Abdominal/sangue , Dor Abdominal/diagnóstico por imagem , Dor Abdominal/etiologia , Acidose/sangue , Injúria Renal Aguda/sangue , Injúria Renal Aguda/diagnóstico por imagem , Injúria Renal Aguda/terapia , Adulto , Comportamento Competitivo , Duodeno/diagnóstico por imagem , Lavagem Gástrica , Obstrução da Saída Gástrica/sangue , Obstrução da Saída Gástrica/diagnóstico por imagem , Obstrução da Saída Gástrica/terapia , Humanos , Hiperfagia/sangue , Hiperfagia/diagnóstico por imagem , Pancreatite/sangue , Pancreatite/diagnóstico por imagem , Pancreatite/terapia , Estômago/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Vômito/sangue , Vômito/diagnóstico por imagem , Vômito/etiologiaRESUMO
BACKGROUND: The management of high anal fistula is often complicated and challenging. In spite of numerous new techniques, the advancement flap technique remained an integral procedure in its management. The purpose of this study was to determine the long-term outcome of advancement flap procedures for high anal fistulas. METHODS: A retrospective review of patients who have undergone an advancement flap procedure for high anal fistula of cryptoglandular origin from June 2003 to April 2012 was performed. Patients were contacted via telephone to evaluate their continence status using the Wexner score. RESULTS: Sixty-one patients with a median age of 48 (range, 19-74) years and a median follow-up of 6.5 (range, 1-59) months were evaluated. Fifty-three (86.9 %) patients had successful surgery while 8 (13.1 %) failed the procedure. Four of them underwent subsequent surgery. Of the 53 patients who had a successful procedure, 27 were successfully contacted for a telephone interview. Twenty-one (77.8 %) of them reported a Wexner score of '0'. Two (7.4 %) patients had a Wexner score of <4, another 2 had a score of '4' and '10', while the last 2 patients had a score of >10. CONCLUSION: Advancement flap procedure is effective in the management of high anal fistulas with an acceptable success rate. The majority of the patients experienced good anal continence.