# Single-Organ Vasculitis Following COVID-19 Infection Resulting in Visceral Arterial Rupture: A Case Report

**Authors:** Yasutaka Saito, Shinichiro Irabu, Hirotaka Yamamoto

PMC · DOI: 10.7759/cureus.87335 · 2025-07-05

## TL;DR

A man in his 50s developed a rare form of vasculitis after a COVID-19 infection, leading to a life-threatening arterial rupture in his abdomen.

## Contribution

This case report highlights a rare complication of COVID-19: single-organ vasculitis causing visceral arterial rupture.

## Key findings

- A patient with recent COVID-19 developed spontaneous rupture of the right gastroepiploic artery.
- Histopathology confirmed necrotizing vasculitis with no systemic causes identified.
- The case was diagnosed as single-organ vasculitis likely triggered by the SARS-CoV-2 infection.

## Abstract

We present the case of a male in his 50s who developed sudden abdominal pain two days after testing positive for coronavirus disease 2019 (COVID-19) and was brought to the emergency department in shock. An emergency laparotomy revealed intraperitoneal hemorrhage due to spontaneous rupture of the right gastroepiploic artery. Histopathological examination revealed necrotizing vasculitis, while systemic causes were excluded. The case was diagnosed as abdominal single-organ vasculitis (SOV) likely triggered by COVID-19. This rare presentation highlights the importance of considering SOV in COVID-19 patients presenting with acute abdomen, as early recognition and intervention are critical to avoid life-threatening hemorrhage.

## Linked entities

- **Diseases:** coronavirus disease 2019 (MONDO:0100096), vasculitis (MONDO:0018882)

## Full-text entities

- **Genes:** CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, ACE2 (angiotensin converting enzyme 2) [NCBI Gene 59272] {aka ACEH}, PRTN3 (proteinase 3) [NCBI Gene 5657] {aka ACPA, AGP7, C-ANCA, CANCA, MBN, MBT}, MPO (myeloperoxidase) [NCBI Gene 4353]
- **Diseases:** pain (MESH:D010146), intra-abdominal bleeding (MESH:D000082122), IgA vasculitis (MESH:D011695), aneurysm (MESH:D000783), SOV (MESH:D012640), tachycardia (MESH:D013610), contrast extravasation (MESH:D005119), shock (MESH:D012769), vascular malformation (MESH:D054079), anemia (MESH:D000740), cutaneous vasculitis (MESH:D018366), necrosis (MESH:D009336), bowel perforation (MESH:D057112), leukocytoclastic vasculitis (MESH:C535509), metabolic acidosis (MESH:D000138), fever (MESH:D005334), inflammation (MESH:D007249), hypotension (MESH:D007022), malignancies (MESH:D009369), endothelial injury (MESH:D057772), Autoimmune and systemic vasculitis (MESH:D056647), tachypnea (MESH:D059246), infections (MESH:D007239), PAN (MESH:D010488), coagulation abnormalities (MESH:D001778), COVID-19 (MESH:D000086382), autoimmune disease (MESH:D001327), deep vein thromboses (MESH:D020246), abdominal pain (MESH:D015746), hematoma (MESH:D006406), abdominal single-organ vasculitis (MESH:D000007), Vasculitis (MESH:D014657), peritonitis (MESH:D010538), blood loss (MESH:D016063), respiratory complications (MESH:D012140), hypertension (MESH:D006973), gastrointestinal involvement (MESH:D005767), acute abdomen (MESH:D000006), Kawasaki-like syndromes (MESH:D009080), bleeding (MESH:D006470), contusion (MESH:D003288), organ dysfunction (MESH:D009102), bowel ischemia (MESH:D007511), hemoperitoneum (MESH:D006465), Rupture (MESH:D012421)
- **Chemicals:** eosin (MESH:D004801), HE (MESH:D006371), EVG (MESH:C509700), hematoxylin (MESH:D006416), Elastica van Gieson (-)
- **Species:** Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12322711/full.md

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Source: https://tomesphere.com/paper/PMC12322711