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A brain CT scan revealed the presence of left middle cerebral artery ischemia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), as well as a platelet count of 25 000/mm<span class="elsevierStyleSup">3</span>, which raised suspicion of vaccine-induced thrombotic thrombocytopenia (VITT). This suspicion was later confirmed with positive antibodies against platelet factor 4. Despite treatment with fondaparinux, corticosteroids, and immunoglobulins, the patient's disease progression was poor, with development of abdominal distension with peritonitis and rapid respiratory deterioration that eventually requiring mechanical ventilation. The abdominal CT scan performed at six hours revealed the presence of enterocolic, pancreatic, and gastric ischemia with extensive thrombosis of the portomesenteric axis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> and <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). 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