Document Type : Case reports


1 Surgical Oncology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Student research committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

4 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Assistant Professor of General Surgery, Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Background: By the end of May 2021, 170 million cases and 3.54 million death from Covid-19 infection have been reported. The high affinity of virus particles to ACE-2 receptors in different body organs can cause varied clinical manifestations and complications. Ischemic colitis and necrosis are some rare complications of Covid-19 infection with high morbidity and mortality resulting from colonic hypoperfusion. Different underlying mechanisms for ischemic colitis in Covid-19 patients have been described, including hypercoagulable state, inflammatory responses, microthrombosis, and non-occlusive intestinal ischemia due to shock, hypoxemia, and low cardiac output.
Case Presentation: here, we presented three patients with ischemic colitis and one rectal necrosis as a rare presentation of gastrointestinal complication of SARS-CoV-2 infection. All of our patients presented with abdominal pain and tenderness and received a standard regimen of antibiotics, anticoagulation, and ventilation support.
Conclusion: Ischemic colitis is one of these rare but with high mortality manifestations, which presents with non-specific signs and symptoms. Hence, ischemic colitis should be kept in mind in patients with Covid-19 infection and abdominal pain, which necessitates further evaluations.


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