Coronavirus disease-19 (COVID-19) infection causing severe gastrointestinal complications is rare. A 9-year-old child after recovering from mild COVID-19 infection developed small bowel gangrene due to superior mesenteric artery thrombosis. He required resection of entire necrotic small bowel along with caecum causing ultra-short bowel syndrome. Reverse transcriptase-polymerase chain reaction (RT-PCR) done on the resected specimen was positive for COVID-19. He was maintained on individualized parenteral nutrition for 3 months. A living donor intestinal transplant was performed using 200 cm of ileum donated by the patient's father. The graft function was satisfactory and was not complicated with thrombosis, infection, reactivation of latent COVID-19 or rejection. He could be weaned off completely from parenteral nutrition by postoperative day 21. The donor had an uneventful recovery. Six month follow-up was satisfactory with the child achieving complete enteral autonomy as well as target goal nutrition. Thrombotic phenomena associated with COVID-19 infection can affect larger vessel-like superior mesenteric artery leading to small bowel gangrene. Intestine transplant could be done safely after 3 months of recovery from COVID-19 without any adverse outcomes. Further studies are required to establish optimal timing and safety of small bowel transplant in this situation.

中文翻译：

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COVID-19 非典型并发症后的小儿活体肠移植：来自印度的独特病例报告

引起严重胃肠道并发症的冠状病毒病 19 (COVID-19) 感染很少见。一名 9 岁的儿童在从轻度 COVID-19 感染中恢复后，由于肠系膜上动脉血栓形成而发展为小肠坏疽。他需要切除整个坏死的小肠以及导致超短肠综合征的盲肠。对切​​除标本进行的逆转录聚合酶链反应 (RT-PCR) 呈 COVID-19 阳性。他维持了 3 个月的个体化肠外营养。使用患者父亲捐赠的 200 厘米回肠进行了活体肠移植。移植物功能令人满意，未并发血栓形成、感染、潜伏 COVID-19 的再激活或排斥反应。到术后第 21 天，他可以完全停止肠外营养。捐赠者恢复顺利。六个月的随访令人满意，孩子实现了完全的肠内自主和目标营养。与 COVID-19 感染相关的血栓现象可影响较大的血管样肠系膜上动脉，导致小肠坏疽。从 COVID-19 恢复 3 个月后，可以安全地进行肠移植，而不会出现任何不良后果。需要进一步研究以确定在这种情况下小肠移植的最佳时机和安全性。与 COVID-19 感染相关的血栓现象可影响较大的血管样肠系膜上动脉，导致小肠坏疽。从 COVID-19 恢复 3 个月后，可以安全地进行肠移植，而不会出现任何不良后果。需要进一步研究以确定在这种情况下小肠移植的最佳时机和安全性。与 COVID-19 感染相关的血栓现象可影响较大的血管样肠系膜上动脉，导致小肠坏疽。从 COVID-19 恢复 3 个月后，可以安全地进行肠移植，而不会出现任何不良后果。需要进一步研究以确定在这种情况下小肠移植的最佳时机和安全性。