Ischemic bowel due to embolization from an isolated mobile thrombus of the ascending aorta: A case report and review of the literature

Jaclyn F. Hechtman, Patrick A. Lento, Irini Scordi-bello

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Aortic thrombi are commonly present in atherosclerotic and aneurysmatic aortas. Thrombus formation in an aorta with or focal atherosclerosis in a patient without risk factors is rare. A 63-year-old woman with dementia and hypothyroidism presented with hypotension and respiratory distress. Work-up revealed leukocytosis, sinus tachycardia, and proximal small bowel obstruction. At emergent laparotomy, a superior mesenteric artery thomboembolus was identified with necrosis of surrounding bowel. The patient expired on hospital day five. Autopsy revealed a 1.4 cm thrombus overlying an isolated atherosclerotic plaque in the ascending aorta and infarctions of the spleen, liver, and right kidney as well as occlusive thromboembolism of the superior mesenteric artery. This case report illustrates lethal complications from an unsuspected aortic thrombus. Work-up for patients presenting with signs of peripheral embolization, or in this case, necrotic bowel, should include the aorta as a source of embolic thrombi.

Original languageEnglish
Pages (from-to)238-241
Number of pages4
JournalJournal of Thrombosis and Thrombolysis
Volume32
Issue number2
DOIs
StatePublished - Aug 2011

Keywords

  • Aorta
  • Floating thrombus
  • Ischemic bowel
  • Thromboembolism

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