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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1247878



Case Details

VAERS ID: 1247878 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Diarrhoea, Lymphadenopathy, Pain, Peripheral vein thrombus extension, Portal vein dilatation, Small intestinal obstruction, Venous thrombosis
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO PAST MEDICAL HISTORY.
Preexisting Conditions: NO PAST MEDICAL HISTORY.
Allergies: NKA
Diagnostic Lab Data: CT ABDOMEN 4/22/2021: IMPRESSION: CT of the abdomen pelvis demonstrates presence of enlargement of the portal vein with peripheral thrombus along the length of the portal vein extending into the intrahepatic veins, right greater left. In addition there appears to be thrombus occluding the central mesenteric vein and the proximal branches with ground-glass density throughout the central mesentery and small lymph nodes. In addition there is a fluid-filled distal small bowel loops with questionable wall thickening , all probably secondary to congestion.
CDC Split Type:

Write-up: Patient states he was doing well until 419 when he had abdominal pain. Patient says abdominal pain started in the middle of his belly and radiated to his back. Pain is worse when he tries to eat and 8 out of 10. Pain is sharp. Patient has not had pain like this before. Pain improved when not eating. Patient has had watery non-bloody diarrhea for the past 2 days. Patient denies any fevers or chills.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247878


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