ABSTRACT
COVID-19 has significantly affected public health, social life, and economies worldwide. The only effective way to combat the pandemic is through vaccines. Although the vaccines have been in use for some time, safety concerns have still been raised. The most typical adverse effects of receiving a COVID-19 vaccine are localized reactions near the injection site, followed by general physical symptoms such as headaches, fatigue, muscle pain, and fever. Additionally, some people may experience VITT (vaccine-induced immune thrombotic thrombocytopenia), a rare side effect after vaccination. We present the case of a 60-year-old female patient that developed VITT-like symptoms with spleno-portal thrombosis and intestinal ischemia two weeks after the administration of the Ad26.COV2-S vaccine. Surgical treatment consisted of extensive bowel resection with end jejunostomy and feeding ileostomy. Two weeks after the first operation, a duodenal-ileal anastomosis was performed. The patient was discharged five weeks after the onset of the symptoms. Although some rare adverse effects are associated with the SARS-CoV-2 vaccines, the risk of hospitalization from these harmful effects is lower than the risk of hospitalization from COVID-19. Therefore, recognizing VITT is significant for ensuring the early treatment of clots and proper follow-up.
ABSTRACT
Background: The multimodal treatment options for cervical carcinoma are represented by either radical hysterectomy associated with pelvic lymph node dissection, pelvic radiation therapy or chemotherapy. Inflammatory and post-neoplasia fibrosis associated with post-radiation fibrosis syndrome (RFS) and lymphedema may cause severe complications and quality of life alteration. Case report: Here we present a case of a 40-year-old woman, seven months after completing standard treatment for squamous cervical cancer FIGO IIA1 with a negative impact on the quality of life due to an important abdominal and retroperitoneal fibrosis leading to significant gastrointestinal symptoms. Over a year, a symptomatic intraabdominal collection and a retroperitoneal abscess were managed in the surgery department by percutaneous drainage and exploratory laparotomy. Bowel obstruction, abscessed pelvic tumor, left colocutaneous and colocolic fistula, intra-abdominal adhesions and left uretero-hydronephrosis were found. Postoperatively, the evolution was unfavorable with upper gastrointestinal bleeding probably due to entero-mesenteric fistula followed by death. Conclusion: Fibrosis can contribute to unfavorable clinical evolution with multiple complications and difficult management. Intra- and retroperitoneal fibrosis, neoplasia and post radiation enteropathy associated with pelvic inflammatory disease make the surgical approach difficult. Diagnosis of retroperitoneal abscess may be challenging due to nonspecific symptoms.
