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Imaging Reveals Bowel Abnormalities in COVID-19 Patients
By MedImaging International staff writers Posted on 03 Jun 2020
Image: Axial (A) and coronal (B) CT of the abdomen suggestive of early ischemia (Photo courtesy of RSNA)
A new study suggests that patients with COVID-19 can have bowel abnormalities, including ischemia, possibly due to small vessel thrombosis.
Researchers at Massachusetts General Hospital (MGH; Boston, USA) and Harvard Medical School (HMS; Boston, MA, USA) conducted a retrospective cross-sectional study that included 412 patients (average age 57 years; 241 men) who had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The medical records of the patients were reviewed for clinical data, which showed that 17% had undergone cross-sectional abdominal imaging, including 44 ultrasounds, 42 computed tomography (CT) scans, and one magnetic resonance imaging (MRI).
The results revealed that abdominal imaging was associated with age and ICU admission. Abnormal bowel findings were seen in 31% of the CT scans (3.2% of all patients). The bowel findings included thickening and signs of ischemia, such as pneumatosis (gas in the bowel wall) and portal venous gas. Surgical correlation in four patients revealed unusual yellow discoloration of the bowel in three of the patients, and bowel infarction (dead bowel) in two patients, in which pathology demonstrated ischemic enteritis with patchy necrosis and fibrin thrombi in the arterioles.
Of the right upper quadrant ultrasounds, 87% were performed for liver laboratory findings, and 54% demonstrated a dilated, sludge-filled gallbladder, suggestive of cholestasis. Four patients who had a cholecystostomy tube placed had negative bacterial cultures. The researchers added that Angiotensin converting enzyme 2 (ACE2), a target of SARS-CoV-2, demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury. The study was published on May 11, 2020, in Radiology.
“We found bowel abnormalities on imaging in patients with COVID-19, more commonly in sicker patients who went to the ICU. Some findings were typical of bowel ischemia, or dying bowel, and in those who had surgery we saw small vessel clots beside areas of dead bowel,” said lead author Rajesh Bhayana, MD, of the MGH department of radiology. “Patients in the ICU can have bowel ischemia for other reasons, but we know COVID-19 can lead to clotting and small vessel injury, so bowel might also be affected by this.”
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(30.994415283203): SELECT id,name,title
FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1
AND id != 294743300
AND id != 294743301
AND id != 294743302
AND id != 294743303
AND id != 294743304
AND id != 294743305
AND id != 294743306
AND id != 294743307
AND id != 294743308
AND id != 294743309
AND id != 294743310
AND metakey != 'aacc'
ORDER BY `ordering`90
(376.93977355957): SELECT show_live FROM jos_com_show_setting LIMIT 191
(501.87110900879): SELECT show_live FROM jos_com_show_setting LIMIT 192
(320.9114074707): SELECT show_live FROM jos_com_show_setting LIMIT 193
(211.95411682129): SELECT show_live FROM jos_com_show_setting LIMIT 194
(370.97930908203): SELECT show_live FROM jos_com_show_setting LIMIT 195
(!!!!! 6556.9877624512): SELECT show_live FROM jos_com_show_setting LIMIT 196
(56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 197
(30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 198
(653.02848815918): SELECT show_live FROM jos_com_show_setting LIMIT 199
(499.01008605957): SELECT show_live FROM jos_com_show_setting LIMIT 1100
(49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1101
(150.91896057129): SELECT show_live FROM jos_com_show_setting LIMIT 1102
(679.96978759766): SELECT show_live FROM jos_com_show_setting LIMIT 1103
(34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1104
(633.00132751465): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1105
(52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1106
(403.88107299805): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294782732
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1107
(391.00646972656): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294782732
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1108
(169.99244689941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1109
(717.1630859375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1110
(257.96890258789): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.id=294782732
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1111
(755.07164001465): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.id=294782732
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1112
(540.97175598145): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp
LEFT JOIN jos_experts as ex
ON ex.id = dp.author
LEFT JOIN jos_deeppockets as dp2
ON dp2.id = dp.fid
WHERE dp.author != 0
AND dp.cat = 10
AND dp.published = 1
AND (
(dp.fid = 294743300)
OR (dp.fid = 294743301)
OR (dp.fid = 294743302)
OR (dp.fid = 294743303)
OR (dp.fid = 294743304)
OR (dp.fid = 294743305)
OR (dp.fid = 294743306)
OR (dp.fid = 294743307)
OR (dp.fid = 294743308)
OR (dp.fid = 294743309)
OR (dp.fid = 294743310)
)
ORDER BY RAND()
LIMIT 1113
(313.04359436035): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp
LEFT JOIN jos_experts as ex
ON ex.id = dp.author
LEFT JOIN jos_deeppockets as dp2
ON dp2.id = dp.fid
WHERE dp.author != 0
AND dp.cat = 10
AND dp.published = 1
AND (
(dp.fid = 294743300)
OR (dp.fid = 294743301)
OR (dp.fid = 294743302)
OR (dp.fid = 294743303)
OR (dp.fid = 294743304)
OR (dp.fid = 294743305)
OR (dp.fid = 294743306)
OR (dp.fid = 294743307)
OR (dp.fid = 294743308)
OR (dp.fid = 294743309)
OR (dp.fid = 294743310)
)
ORDER BY RAND()
LIMIT 1114
(86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1115
(59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1116
(57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1117
(36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1118
(49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1119
(37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1120
(41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1121
(63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1122
(323.05717468262): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`123
(!!!!! 59592.008590698): SELECT
*
FROM
jos_deeppockets
WHERE
jos_deeppockets.cat = 10
AND
jos_deeppockets.type = 'deeppockets_item'
AND
jos_deeppockets.published = 1
AND
jos_deeppockets.created + INTERVAL 14 DAY >= NOW()
ORDER BY
jos_deeppockets.hits DESC
LIMIT
7124
(!!!!! 7449.1500854492): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294782732 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294782732 AND type='deeppockets_item' AND published='1' LIMIT 1125
(549.0779876709): (
SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.video != ''
AND
dp.video_source != ''
AND
dp.cat = 10
AND
dp.published = 1
AND
dp.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
UNION
(
SELECT
dpa.id,
dpa.name,
dpa.title,
dpa.video,
dpa.video_source,
dpa.created
FROM
jos_deeppockets_archive AS dpa
WHERE
dpa.video != ''
AND
dpa.video_source != ''
AND
dpa.cat = 10
AND
dpa.published = 1
AND
dpa.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
ORDER BY
created DESC
LIMIT
3126
(496.14906311035): (
SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.video != ''
AND
dp.video_source != ''
AND
dp.cat = 10
AND
dp.published = 1
AND
dp.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
UNION
(
SELECT
dpa.id,
dpa.name,
dpa.title,
dpa.video,
dpa.video_source,
dpa.created
FROM
jos_deeppockets_archive AS dpa
WHERE
dpa.video != ''
AND
dpa.video_source != ''
AND
dpa.cat = 10
AND
dpa.published = 1
AND
dpa.type != 'deeppockets_item_link'
ORDER BY
created DESC
LIMIT
3
)
ORDER BY
created DESC
LIMIT
3127
(176.90658569336): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803337
LIMIT 1128
(171.89979553223): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803337
LIMIT 1129
(161.88621520996): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803276
LIMIT 1130
(138.99803161621): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294803276
LIMIT 1131
(164.98565673828): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets_archive AS dp
WHERE
dp.id = 294803276
LIMIT 1132
(30.994415283203): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets_archive AS dp
WHERE
dp.id = 294803276
LIMIT 1133
(29.802322387695): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294802958
LIMIT 1134
(119.92454528809): SELECT
dp.id,
dp.name,
dp.title,
dp.video,
dp.video_source,
dp.created
FROM
jos_deeppockets AS dp
WHERE
dp.id = 294802958
LIMIT 1135
(448.94218444824): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294782732
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 1136
(341.17698669434): SELECT *
FROM jos_deeppockets_archive
WHERE 1=1
AND id=294782732
AND (type='deeppockets_item' OR type='deeppockets_item_link')
AND published='1'
LIMIT 1137
(50.067901611328): SELECT name FROM jos_deeppockets WHERE id=215138
(36.001205444336): SELECT name FROM jos_deeppockets WHERE id=215139
(738.14392089844): SELECT *,
DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up,
DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down
FROM jos_events
WHERE state=1
AND publish_up > NOW()
and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110)
ORDER BY publish_up ASC LIMIT 3140
(736.95182800293): SELECT *,
DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up,
DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down
FROM jos_events
WHERE state=1
AND publish_up > NOW()
and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110)
ORDER BY publish_up ASC LIMIT 3141
(!!!!! 1111.9842529297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1142
(68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1143
(!!!!! 12232.065200806): TRUNCATE TABLE jos_trademed_module144
(406.02684020996): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294782732
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1145
(195.98007202148): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp
LEFT JOIN jos_experts as exp
ON exp.id = dp.author
LEFT JOIN jos_deeppockets as ch
ON dp.fid = ch.id
WHERE 1=1
AND dp.cat=10
AND dp.id=294782732
AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
AND dp.published='1' LIMIT 1146
(455.14106750488): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294782732
AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1147
(!!!!! 8153.9154052734): SELECT *
FROM jos_deeppockets
WHERE 1=1
AND id=294782732
AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1148
(309.94415283203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1149
(73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1150
(!!!!! 3736.0191345215): SELECT jos_item.*
FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id
WHERE 1=1
AND (jos_item.imgMini<>'')
AND jos_item.type='L'
AND jos_item.numberID= (
SELECT jos_number.id
FROM jos_number
WHERE jos_number.journalID IN (10)
and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P')
ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC
LIMIT 0,1
)
ORDER BY RAND() DESC LIMIT 6151
(114.20249938965): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1152
(142.09747314453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1153
(97.990036010742): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294782732 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294782732 AND type='deeppockets_item' AND published='1' LIMIT 1154
(58.889389038086): select distinct links.*
from jos_textlinks links
join jos_textlinks_placement placement on links.id=placement.link_id
where journal_id=(10) and (channel_id=215 or channel_id is null)155
(40.054321289062): select distinct links.*
from jos_textlinks links
join jos_textlinks_placement placement on links.id=placement.link_id
where journal_id=(10) and (channel_id=215 or channel_id is null)156
(57.93571472168): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1157
(106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1158
(66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294782732 AND published='1'
union
SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294782732 AND published='1'
LIMIT 1159
(171.89979553223): select jos_twitters.link from jos_twitters where cat=10160
(43.153762817383): select jos_facebook.link from jos_facebook where cat=10161
(36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10162
(35.04753112793): select jos_linkedin.link from jos_linkedin where cat=10163
(395.05958557129): update jos_bannersmanager_banner
set impmade=impmade+1
where id in(14202,14203)164
(!!!!! 3914.1178131104): insert into jos_banners_delta values (14202,'2025-08-25 12:47:57','216.73.216.114','view'),(14203,'2025-08-25 12:47:57','216.73.216.114','view')
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