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07 September 2022: Articles

A Case of Segmental Arterial Mediolysis of Multiple Visceral Arteries Following Anti-COVID-19 Vaccination: Late Complication or Rare Coincidence?

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Unexpected drug reaction , Clinical situation which can not be reproduced for ethical reasons

Akihiro Takeda A* , Wataru Koike B , Fumihiro Okumura B

DOI: 10.12659/AJCR.937505

Am J Case Rep 2022; 23:e937505

Table 3. The reported cases of visceral arterial lesions suspected to be related to anti-COVID-19 mRNA vaccination.

Case numberReferenceYearAge (years)SexDiagnosisPredisposing conditionType of anti-COVID-19 vaccine
1[]7 202250MaleImmunomediated sequential dissection of visceral arteriesSmoker and hypertensionPfizer-BioNTech mRNA
2[]8 202252FemaleSpontaneous visceral pseudoaneurysm of the inferior pancreaticoduodenal artery with ruptureSuspected cholelithiasisModerna mRNA
3Current case202268MaleSegmental arterial mediolysis of the multiple visceral arteriesGastric ulcer and paroxysmal atrial tachycardiaPfizer-BioNTech mRNA
Case numberNumber of vaccinationsDuration from vaccination to symptom onset (days)Signs and symptomsImaging findingsManagementPrognosis
1Not mentionedA few daysIntense abdominal pain and vomiting for 2 daysFocal dissection of the celiac trunk with intramural hematoma reaching the splenic, hepatic, and gastric arteries without signs of intestinal ischemia, bilateral thrombosis of the renal arteries with renal ischemia, due to probable dissection and dissection of the superior mesenteric arteryAntihypertensive therapy, antiplatelet therapy, and anticoagulant therapy followed by corticosteroids and intravenous immunoglobulinsA symptomatic with normalization of the renal and superior mesenteric arteries, with residual isolated dissection of the celiac trunk
222A sharp, constant right upper quadrant and epigastric painRuptured pseudoaneurysm of the inferior pancreaticoduodenal artery with large hematomaTranscatheter arterial embolizationUnremarkable recovery
3358Upper abdominal pain and nauseaStenosis and dilatation of multiple visceral arteries, including middle and right colic arteries, and omental arteries with arterial dissection of the left epiploic arteryObservationSpontaneous resolution

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923