{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:44:04Z","timestamp":1774611844980,"version":"3.50.1"},"reference-count":27,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,4]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>The novel coronavirus SARS-CoV-2 became a global pandemic in late 2019, and is still ongoing in 2021 causing significant morbidity and mortality. The advent of vaccinations heralded the turning of the tide. The Oxford jab, a vector-based vaccine was favoured due to its low cost and ease of storage. However, its potential association with thromboembolic adverse events resulted in controversy and disrupted its roll-out and use. The aetiopathogenesis of these thromboembolic events and its association with the Oxford vaccine are still speculative and uncertain, more so in the background of SARS-CoV-2 infection being highly thrombogenic in its own right. This paper presents a case of an otherwise healthy 50-year-old Caucasian man who developed acute abdominal pain 7\u2009days following the first dose of Oxford vaccine and was found to have coeliac and splenic artery thrombosis complicated with splenic infarction.<\/jats:p>","DOI":"10.1136\/bcr-2021-243799","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T12:16:54Z","timestamp":1626265014000},"page":"e243799","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Coeliac artery and splenic artery thrombosis complicated with splenic infarction 7 days following the first dose of Oxford vaccination, causal relationship or coincidence?"],"prefix":"10.1136","volume":"14","author":[{"given":"Sareesh","family":"Bandapaati","sequence":"first","affiliation":[{"name":"Emergency Department, Kettering General Hospital, Kettering, Northamptonshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemababu","family":"Bobba","sequence":"additional","affiliation":[{"name":"Emergency Department, Kettering General Hospital, Kettering, Northamptonshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitrakrishnan Rayno","family":"Navinan","sequence":"additional","affiliation":[{"name":"Cardiology Department, Kettering General Hospital, Kettering, Northamptonshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,14]]},"reference":[{"key":"2025082712285634000_14.7.e243799.1","unstructured":"WHO . WHO Coronavirus(COVID 19) Dashboard Word Health Organization, 2021. Available: https:\/\/covid19.who.int\/table [Accessed 17 Apr 2021]."},{"key":"2025082712285634000_14.7.e243799.2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/S0140-6736(20)32623-4","article-title":"Oxford-AstraZeneca COVID-19 vaccine efficacy","volume":"397","author":"Knoll","year":"2021","journal-title":"Lancet"},{"key":"2025082712285634000_14.7.e243799.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n728"},{"key":"2025082712285634000_14.7.e243799.4","unstructured":"EMA . AstraZeneca\u2019s COVID-19 vaccine: EMA finds possible link to very rare cases of unusual blood clots with low blood platelets: European Medicine Agency, 2021. Available: https:\/\/www.ema.europa.eu\/en\/news\/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-cases-unusual-blood-clots-low-blood [Accessed 16 Apr 2021]."},{"key":"2025082712285634000_14.7.e243799.5","unstructured":"Signal assessment report on embolic and thrombotic events (SMQ) with COVID-19 Vaccine (ChAdOx1-S [recombinant]) \u2013 COVID-19 Vaccine AstraZeneca (Other viral vaccines), 2021. Available: https:\/\/www.ema.europa.eu\/en\/documents\/prac-recommendation\/signal-assessment-report-embolic-thrombotic-events-smq-covid-19-vaccine-chadox1-s-recombinant-covid_en.pdf [Accessed 14 Apr 2021]."},{"key":"2025082712285634000_14.7.e243799.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/741653","article-title":"Celiac artery thrombosis and superior mesenteric artery stenoses with essential thrombocythemia: a case report","volume":"2012","author":"Keskin","year":"2012","journal-title":"Case Rep Med"},{"key":"2025082712285634000_14.7.e243799.7","doi-asserted-by":"crossref","DOI":"10.1186\/1757-1626-3-82","article-title":"Acute occlusion of the celiac axis and its branches with perforation of gastric fundus and splenic infarction, findings on spiral computed tomography: a case report","volume":"3","author":"Kelekis","year":"2010","journal-title":"Cases J"},{"key":"2025082712285634000_14.7.e243799.8","first-page":"273","article-title":"Coeliac artery thrombosis: an uncommon cause of an acute abdomen","volume":"66","author":"Saravana","year":"2011","journal-title":"Med J Malaysia"},{"key":"2025082712285634000_14.7.e243799.9","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.diii.2015.04.010","article-title":"Acute celiac trunk thrombosis revealed by biliary peritonitis","volume":"96","author":"Jerraya","year":"2015","journal-title":"Diagn Interv Imaging"},{"key":"2025082712285634000_14.7.e243799.10","unstructured":"MHRA . Coronavirus Vaccine - summary of Yellow Card reporting: MHRA, 2021. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/994726\/20210616_Coronavirus_vaccine_-_summary_of_Yellow_Card_reporting__v2_-_clean.pdf [Accessed 20 Jun 2021]."},{"key":"2025082712285634000_14.7.e243799.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n774"},{"key":"2025082712285634000_14.7.e243799.12","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1016\/S0140-6736(21)00762-5","article-title":"Thromboembolism and the Oxford\u2013AstraZeneca COVID-19 vaccine: side-effect or coincidence?","volume":"397","author":"\u00d8stergaard","year":"2021","journal-title":"The Lancet"},{"key":"2025082712285634000_14.7.e243799.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n883"},{"key":"2025082712285634000_14.7.e243799.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1114"},{"key":"2025082712285634000_14.7.e243799.15","doi-asserted-by":"crossref","unstructured":"et al Greinacher AT , Warkentin T , Weisser ET . A prothrombotic thrombocytopenic disorder resembling heparin-induced thrombocytopenia following Coronavirus-19 vaccination, 2021. Available: https:\/\/www.researchsquare.com\/article\/rs-362354\/v1 [Accessed 1 Apr 2021].","DOI":"10.21203\/rs.3.rs-362354\/v2"},{"key":"2025082712285634000_14.7.e243799.16","doi-asserted-by":"crossref","unstructured":"Kowarz E , Krutzke L , Reis J , et al . Vaccine-Induced Covid-19 Mimicry\u201d Syndrome: Splice reactions within the SARS-CoV-2 Spike open reading frame result in Spike protein variants that may cause thromboembolic events in patients immunized with vector-based vaccines. Preprint from Research Square, 2021.","DOI":"10.21203\/rs.3.rs-558954\/v1"},{"key":"2025082712285634000_14.7.e243799.17","unstructured":"WHO . COVID-19 vaccines: safety surveillance Manual- module: responding to adverse events following COVID-19 immunization (AEFIs). WHO, 2020. https:\/\/www.who.int\/vaccine_safety\/committee\/Module_AEFI.pdf?ua=1"},{"key":"2025082712285634000_14.7.e243799.18","unstructured":"WHO . Causality assessment of an adverse event following immunization (AEFI), 2018: 68."},{"key":"2025082712285634000_14.7.e243799.19","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1056\/NEJMe2106315","article-title":"SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia","volume":"384","author":"Cines","year":"2021","journal-title":"N Engl J Med"},{"key":"2025082712285634000_14.7.e243799.20","unstructured":"Diagnosis and management of gastrointestinal manifestations of vaccine induced thrombosis & thrombocytopenia (VITT) syndrome, 2021. Available: https:\/\/www.rcseng.ac.uk\/-\/media\/files\/rcs\/coronavirus\/vitt-guidance-gi-manifestations-6-may-2021.pdf"},{"key":"2025082712285634000_14.7.e243799.21","unstructured":"RCEM R, SAM,EHP,BSNR . Management of patients presenting to the emergency Department\/ acute medicine with symptoms, 2021. Available: https:\/\/www.rcem.ac.uk\/docs\/Policy\/ED-AM%20%20Vaccine%20pathway%20concerns%20-%20RCP%20-%20SAM%20-%20RCEM.pdf [Accessed 16 Apr 2021]."},{"key":"2025082712285634000_14.7.e243799.22","doi-asserted-by":"crossref","first-page":"2529","DOI":"10.1007\/s10067-020-05275-1","article-title":"Thrombosis in coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad","volume":"39","author":"Ahmed","year":"2020","journal-title":"Clin Rheumatol"},{"key":"2025082712285634000_14.7.e243799.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12959-020-00255-6","article-title":"Fatal pulmonary arterial thrombosis in a COVID-19 patient, with asymptomatic history, occurred after swab negativization","volume":"19","author":"Del Nonno","year":"2021","journal-title":"Thromb J"},{"key":"2025082712285634000_14.7.e243799.24","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1007\/s00270-021-02824-2","article-title":"Endovascular revascularization with stent implantation in patients with acute mesenteric ischemia due to acute arterial thrombosis: clinical outcome and predictive factors","volume":"44","author":"Pedersoli","year":"2021","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025082712285634000_14.7.e243799.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2010.02.001"},{"key":"2025082712285634000_14.7.e243799.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2006.06130.x"},{"key":"2025082712285634000_14.7.e243799.27","doi-asserted-by":"crossref","DOI":"10.1093\/ajcp\/aqz112.068","article-title":"Pt and aPTT are not predictors of thromboembolic events","volume":"152","author":"Shervinrad","year":"2019","journal-title":"Am J Clin Pathol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:29:07Z","timestamp":1756322947000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":27,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,14]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-243799"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243799","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}