Rare intestinal gangrene found among four Covid-hit, 2 dead | Sidnaz Blog

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Hyderabad: Not just the lungs; the deadly coronavirus seems to be damaging the small intestine of patients as well. Since the start of the pandemic, the Osmania General Hospital (OGH) alone has reported at least four cases of a rare intestinal gangrene — all among people who had previously recovered from a bout of Covid-19. While one among these was referred to OGH during the first wave, the other three came to the hospital’s notice during the ongoing second wave.
According to doctors, the gangrene is caused due to Covid-19-induced blood clots that have so far been commonly found in the blood vessels of patients’ lungs. It requires removal of the small intestine leaving patients unable to eat any food. A patient either has to be on intravenous feeding for life or undergo an intestinal transplant.
Of the four patients at OGH, one has already had a transplant while another is due to undergo it soon. Two other patients — from Wanaparthy and AP — succumbed to the complications, doctors said.
“Once the small intestine is removed, a person cannot intake any food and can only be kept on total parenteral nutrition (TPN) (a method of feeding that bypasses the gastrointestinal tract). During the first case, we had a 20-year-old girl who had developed full bowel gangrene and after the removal of the organ, her father managed to keep her under TPN for four months. An intestinal transplant was then done. Currently, a 60-year-old patient from Mahabubnagar is awaiting transplant,” said Dr C Madhusudan, head of the department of gastroenterology and transplant surgeon, OGH.
He added that the incidence of blockages in intestinal blood vessels and bowel gangrene is increasing with Covid-19.
Just like clots in blood vessels connecting the heart and brain result in cardiac arrest or brain stroke, in case of intestinal vessels the blockage cuts off blood supply to the intestines, which results in gangrene. Such patients present with sudden onset of severe abdominal pain, gradual increase in heart rate, increase in abdominal distension and hypotension.
While these cases were few and far between earlier, most of those were reported among the elderly. “We used to see a case once in two-three years among elderly patients with diabetes, high blood pressure, high level of cholesterol etc. But now, we are seeing these cases among young people too,” said the doctor. He said that many patients are being put on blood thinners for two-three months, post Covid-19 recovery, to avoid such life threatening events.
Doctors, therefore, asked post Covid-19 patients to alert to any discomfort in the abdomen.
“The pathology of the disease is such that there is a tendency to develop clots. It is not possible to anticipate which patient will develop a clot. However, if there is loss of blood supply to part of the body, say intestine, and it is not removed in appropriate time, it will be followed by gangrene. For instance if a patient has pain in the abdomen but takes some over the counter medicine and stays at home for five days, the damage would be done. Seeking timely medical attention is important,” said a senior doctor from the Telangana Institute of Medical Sciences and Research (TIMSR), Gachibowli.

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