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Necrotic Hemorrhagic Pancreatitis in COVID 19 Patient: a Case Report

XX Congresso Regionale FADOI CAMPANIA: Non ci siamo mai fermati
Italy 2021

Bologna C*, Mazzella F, Coppola MG, Rabitti PG, Madonna P

Internal Medicine Unit, Ospedale del Mare, Naples, Italy,
Azienda dei Colli Ospedale Cotugno, Naples, Italy
Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Naples, Italy

Posters & Accepted Abstracts: Health Sci J

Abstract:

Background: Approximately 10% of COVID 19 positive patients present with only gastrointestinal symptoms. Acute pancreatitis may be a consequence of direct damage by the virus because pancreatic acinar cells contain angiotensin-converting enzyme 2 receptor proteins Case History: 65-year-old presented with abdominal pain and fever. He has lymphopenia, elevated pancreatic enzymes and elevated C reactive protein in the absence of respiratory signs and symptoms. Positive for SARSCOV2 molecular swab. After a week, it has been observed higher levels of interleukin 6 with evolution in necrotic hemorrhagic pancreatitis with sac-like fluid collections that compresses the superior mesenteric vein and marked suffering of all the jejunoileal loops. He undergoes positive surgical drainage for Acinetobacter baumanni. The patient presented severe pneumonia with the need for noninvasive ventilatory support and followed by acute worsening renal failure with dialysis urgency leading to the patient's death. Discussion: this infectious picture started with acute nonobstructive pancreatitis, which then became complicated with pneumonia and a multiorgan failure probably due to the cytokine storm, common mechanism in pancreatitis of any origin. It is very suggestive to think of a direct cytotoxic action of the virus, but more studies are needed to demonstrate a direct SARSCOV2 pathophysiological mechanism. References 1. de-Madaria E, Capurso G (2021) COVID-19 and acute pancreatitis: examining the causality. Nat Rev Gastroenterol Hepatol 18: 3-4. 2. JabÅÂÂ�?oÅÂÂ�?ska B, Olakowski M, Mrowiec S (2021) Association between acute pancreatitis and COVID-19 infection: What do we know? World J Gastrointest Surg 13: 548-562.