07 September 2022
: Case report 
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 Takeda1ABCDEF*, Wataru Koike2BCD, Fumihiro Okumura3BCDDOI: 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 number | Reference | Year | Age (years) | Sex | Diagnosis | Predisposing condition | Type of anti-COVID-19 vaccine |
|---|---|---|---|---|---|---|---|
| 1 | []7 | 2022 | 50 | Male | Immunomediated sequential dissection of visceral arteries | Smoker and hypertension | Pfizer-BioNTech mRNA |
| 2 | []8 | 2022 | 52 | Female | Spontaneous visceral pseudoaneurysm of the inferior pancreaticoduodenal artery with rupture | Suspected cholelithiasis | Moderna mRNA |
| 3 | Current case | 2022 | 68 | Male | Segmental arterial mediolysis of the multiple visceral arteries | Gastric ulcer and paroxysmal atrial tachycardia | Pfizer-BioNTech mRNA |
| Case number | Number of vaccinations | Duration from vaccination to symptom onset (days) | Signs and symptoms | Imaging findings | Management | Prognosis | |
| 1 | Not mentioned | A few days | Intense abdominal pain and vomiting for 2 days | Focal 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 artery | Antihypertensive therapy, antiplatelet therapy, and anticoagulant therapy followed by corticosteroids and intravenous immunoglobulins | A symptomatic with normalization of the renal and superior mesenteric arteries, with residual isolated dissection of the celiac trunk | |
| 2 | 2 | 2 | A sharp, constant right upper quadrant and epigastric pain | Ruptured pseudoaneurysm of the inferior pancreaticoduodenal artery with large hematoma | Transcatheter arterial embolization | Unremarkable recovery | |
| 3 | 3 | 58 | Upper abdominal pain and nausea | Stenosis and dilatation of multiple visceral arteries, including middle and right colic arteries, and omental arteries with arterial dissection of the left epiploic artery | Observation | Spontaneous resolution |