Covid can also affect abdominal organs and the gastrointestinal system. And “in patients with abdominal and gastrointestinal symptoms, the most suitable radiological examinations are computed tomography with multiphase acquisition, and partially also ultrasound. In fact, although the virus does not determine specific radiological signs in the abdominal and gastrointestinal districts, the contribution offered by diagnostics images can help the clinician in the diagnosis, in the estimate of the severity and in the prognosis of the disease “. This is what is indicated in a review article recently published in the ‘World Journal of Gastroenterology’, the result of the collaboration between the radiological schools of Pisa and Naples.
The article bears the signature of Piero Boraschi, radiologist of the Radiodiagnostic 2 operating unit of the Pisa hospital-university company, assisted by Francescamaria Donati of the same structure, by Stefania Romano (Radiology operating unit of the Pozzuoli hospital, Naples of Aoup.
The publication, reports a note from the Aoup, highlights how Covid-19 – a systemic pathology that mainly affects the vascular system and the lungs, causing in the most serious cases, severe respiratory failure which is then the main cause of death in patients who are affected – may actually also involve the gastrointestinal tract, the hepatobiliary system, the pancreas, the urinary tract and the spleen.
The most prominent radiological signs – the experts detail – are the thickening of the intestinal wall, sometimes associated with hyperemia and mesenteric thickening, and the fluid distension of the large intestine. Signs of intestinal ischemia or pneumatosis are rarely present. The most frequent radiological manifestations of hepatic involvement are hepatic steatosis, mud and biliary lithiasis. More rarely, acute edematous pancreatitis, renal infarction and acute renal injury from acute tubular necrosis may be present in Covid patients. Finally, the involvement of the spleen in Covid-19 is characterized by an increase in size (splenomegaly) and by solitary or multifocal splenic infarcts with classic wedge-shaped or even rounded morphology, with irregular or smooth profiles (edm).