A Case Report of Mesenteric Ischemia After COVID-19 Vaccination

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.