Acute abdomen following COVID-19 vaccination: a systematic review

Abstract

Purpose Conduct a systematic review of case reports and case series regarding the development of acute abdomen following coronavirus disease 2019 (COVID-19) vaccination, to describe the possible association and the clinical and demographic characteristics in detail. Materials and Methods This study included case report studies and case series that focused on the development of acute abdomen following COVID-19 vaccination. Systematic review studies, literature, letters to the editor, brief comments, and so forth were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Briggs Institute tool was used to assess the risk of bias and the quality of the study. Descriptive data were presented as frequency, median, mean, and standard deviation. Results Seventeen clinical case studies were identified, evaluating 17 patients with acute abdomen associated with COVID-19 vaccination, which included acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2), and colitis (n=2). The COVID-19 vaccine most commonly linked to acute abdomen was Pfizer-BioNTech (messenger RNA), accounting for 64.71% of cases. Acute abdomen predominantly occurred after the first vaccine dose (52.94%). All patients responded objectively to medical (88.34%) and surgical (11.76%) treatment and were discharged within a few weeks. No cases of death were reported. Conclusion Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination. Our study is based on a small sample of patients; therefore, it is recommended to conduct future observational studies to fully elucidate the underlying mechanisms of this association.

Exploring Acute Pancreatitis in Kidney Transplant Recipients: A Multicentre Retrospective Cohort Analysis of Incidence, Causes, and Clinical Outcomes

“…They hypothesized that this fact may be the consequence of a higher degree of disease severity in patients with acute COVID-19, but also because patients have both lung damage and pronounced acute pancreatitis severity [ 48 ]. Although acute pancreatitis was recorded after vaccination against SARS-CoV-2 [ 49 ], the probability of the vaccine as the etiologic factor of acute pancreatitis is not conclusive. SARS-CoV-2 vaccine-induced pancreatitis is considered to involve different mechanisms including direct virus-mediated injury, systemic inflammatory response, circulating proinflammatory interleukins, virus-induced lipotoxicity, and drug-induced injury [ 50 ], while possible mechanisms associated with pancreatic tissue damage may include molecular mimicry, polyclonal activation of lymphocytes, activation of self-reactive lymphocytes, and vaccine-triggered release of histamine and leukotrienes [ 51 , 52 ].…”