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Article in Japanese
A case of coronavirus disease 2019 pneumonia complicated by rupture of an inferior pancreaticoduodenal artery aneurysm, deep vein thrombosis, and pulmonary thromboembolism
Takashi Funasakaa Hiromichi Asob Akira Fukushimab Yuko Nishinagab Takahiro Shimizub Chiaki Yamadab
aDepartment of Respiratory Medicine, Ogaki Municipal Hospital
bDepartment of Respiratory Medicine, Ichinomiya Municipal Hospital
A 74-year-old female presented to her local doctor with dyspnea on exertion. Computed tomography (CT) revealed ground-glass opacities in both lungs. We made a diagnosis of coronavirus disease 2019 (COVID-19) because severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) tests were positive. After that, she developed worsening respiratory failure and required mechanical ventilation for 7 days. On day 11, she suddenly complained of abdominal pain. Contrast-enhanced CT showed a retroperitoneal hematoma with extravasation around the pancreas and stenosis of the celiac artery. Selective angiography showed an aneurysm with slight extravasation from the inferior pancreaticoduodenal artery. She was treated by performing transcatheter arterial embolization (TAE). On day 40, contrast-enhanced CT showed a pulmonary thromboembolism (PTE) in the right pulmonary artery and deep vein thrombosis (DVT) from the right common iliac vein to the right femoral vein. To prevent worsening of the PTE, we implanted an inferior vena cava filter. This is a rare case of both a hemorrhage event due to a ruptured aneurysm and thrombosis in a COVID-19 patient.
Coronavirus disease 2019 (COVID-19) Median arcuate ligament syndrome (MALS) Ruptured aneurysm Pulmonary thromboembolism (PTE) Deep vein thrombosis (DVT)
Received 27 Jul 2021 / Accepted 12 May 2022
AJRS, 11(4): 193-197, 2022