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A Case Report of Mesenteric Ischemia After COVID-19 Vaccination

Received: 21 July 2021    Accepted: 6 August 2021    Published: 31 August 2021
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Abstract

The United States has vaccinated almost 200 million citizens in the first 7 months of 2021. During that period adverse events have been described from minor complaints of redness, pain and swelling at the injection site to more serious events such as Guillain Barre Syndrome and thrombosis. As vaccination distribution continue to move forward, more side effects and complications will become evident. This case report is of a patient presenting in shock 4 days after receiving her second COVID-19 vaccination with altered mental status, dyspnea, and an acute abdomen with a bowel perforation. After resuscitation, the patient was taken to surgery where an additional diagnosis of embolic mesenteric arterial ischemia was made on exploratory laparotomy. While a causal relationship between the vaccine and the findings in this particular patient cannot be proven, there certainly is a temporal relationship between her receiving the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine, the presentation of this patient to our institution, and the findings during emergency surgery. Thromboses are known adverse events from the COVID-19 vaccines however to our knowledge, there has not been a published case report of embolic mesenteric arterial ischemia after receiving a COVID-19 vaccine. Appreciating the association between COVID-19 vaccines and embolic mesenteric arterial ischemia should alert physicians to keep this diagnosis high on their differential in the setting of unusual abdominal pain and recent vaccination.

Published in Journal of Surgery (Volume 9, Issue 4)
DOI 10.11648/j.js.20210904.23
Page(s) 216-219
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pfizer-BioNTech COVID-19 Vaccine, COVID-19 Vaccine Adverse Event, Mesenteric Ischemia

References
[1] “COVID-19 Vaccinations in the United States.” CDC website, 27 July, 2021, www.covid.cdc.gov/covid-data-tracker/#vaccinations.
[2] “Selected Adverse Events Reported after COVID-19 Vaccination.” CDC website, 20 June, 2021, www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html#:~:text=Results%20from%20monitoring%20efforts%20are,COVID%2D19%20vaccination.
[3] “Vaccine Adverse Event Reporting System.” VAERS website, 20 July, 2021, www.vaers.hhs.gov/.
[4] Singj, Balraj. “COVID-19 and Acute Mesenteric Ischemia: A Review of Literature.” Hematol Transfus Cell Ther. 2021; Jan-Mar; 43 (1) 112-116.
[5] “Safety of COVID-19 Vaccines.” CDC Website, 12 July, 2021, www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html.
[6] “Data reveal fewer real-world COVID vaccine side effects.” Center for Infectious Disease Research and Policy, 28 April, 2021, www.cidrap.umn.edu/news-perspective/2021/04/data-reveal-fewer-real-world-covid-vaccine-side-effects.
[7] “How Common Are Your COVID-19 Vaccine Side Effects?” Smithsonian Magazine, 4 May, 2021, www.smithsonianmag.com/smart-news/find-out-how-common-your-covid-19-vaccine-side-effects-are-180977656/.
[8] Menni, Cristina. “Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study”, Lancet Infect Dis 2021; 21: 939–49, Published Online April 27, 2021, https://doi.org/10.1016/S1473-3099(21)00224-3.
[9] Bikdeli B, et al. “Cerebral Venous Sinus Thrombosis in the US Population, After Adenovirus-Based SARS-CoV-2 Vaccination, and After COVID-19.” J Am Coll Cardiol 2021; Jun 8.
[10] Williams, Shawna. “Blood Clot Risk from COVID-19 Higher than After Vaccines: Study,” The Scientist. April 16, 2021. www.the-scientist.com/news-opinion/blood-clot-risk-from-COVID-19-higher-than-after-vaccines-study-68675.
[11] PubMed Website search for COVID-19 vaccine and mesenteric ischemia, www.pubmed.ncbi.nlm.nih.gov/?term=COVID+vaccine+and+mesenteric+ischemia&schema=all.
[12] Marie Scully, M. D. “Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination.” NEJM. 2021; 384: 2202-2211, DOI: 10.1056/NEJMoa2105385.
[13] Nina H. Schultz, M. D., Ph.D. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. NEJM. 2021; DOI: 10.1056/NEJMoa2104882.
[14] Bala, M. et al. “Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery.” World J Emerg Surg 12, 38 (2017). https://doi.org/10.1186/s13017-017-0150-5.
[15] Oldenburg, W. A. et al. Acute Mesenteric Ischemia: A Clinical Review, Arch Intern Med. 2004; 164 (10): 1054-1062. DOI: 10.1001/archinte.164.10.1054.
Cite This Article
  • APA Style

    Sean Christopher Gaudio, Frank Eugene Gaudio. (2021). A Case Report of Mesenteric Ischemia After COVID-19 Vaccination. Journal of Surgery, 9(4), 216-219. https://doi.org/10.11648/j.js.20210904.23

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    ACS Style

    Sean Christopher Gaudio; Frank Eugene Gaudio. A Case Report of Mesenteric Ischemia After COVID-19 Vaccination. J. Surg. 2021, 9(4), 216-219. doi: 10.11648/j.js.20210904.23

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    AMA Style

    Sean Christopher Gaudio, Frank Eugene Gaudio. A Case Report of Mesenteric Ischemia After COVID-19 Vaccination. J Surg. 2021;9(4):216-219. doi: 10.11648/j.js.20210904.23

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  • @article{10.11648/j.js.20210904.23,
      author = {Sean Christopher Gaudio and Frank Eugene Gaudio},
      title = {A Case Report of Mesenteric Ischemia After COVID-19 Vaccination},
      journal = {Journal of Surgery},
      volume = {9},
      number = {4},
      pages = {216-219},
      doi = {10.11648/j.js.20210904.23},
      url = {https://doi.org/10.11648/j.js.20210904.23},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210904.23},
      abstract = {The United States has vaccinated almost 200 million citizens in the first 7 months of 2021. During that period adverse events have been described from minor complaints of redness, pain and swelling at the injection site to more serious events such as Guillain Barre Syndrome and thrombosis. As vaccination distribution continue to move forward, more side effects and complications will become evident. This case report is of a patient presenting in shock 4 days after receiving her second COVID-19 vaccination with altered mental status, dyspnea, and an acute abdomen with a bowel perforation. After resuscitation, the patient was taken to surgery where an additional diagnosis of embolic mesenteric arterial ischemia was made on exploratory laparotomy. While a causal relationship between the vaccine and the findings in this particular patient cannot be proven, there certainly is a temporal relationship between her receiving the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine, the presentation of this patient to our institution, and the findings during emergency surgery. Thromboses are known adverse events from the COVID-19 vaccines however to our knowledge, there has not been a published case report of embolic mesenteric arterial ischemia after receiving a COVID-19 vaccine. Appreciating the association between COVID-19 vaccines and embolic mesenteric arterial ischemia should alert physicians to keep this diagnosis high on their differential in the setting of unusual abdominal pain and recent vaccination.},
     year = {2021}
    }
    

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Author Information
  • School of Medicine, Georgetown University, Washington, the United States

  • Emergency Department, the Washington Health System, Washington, the United States

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