Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:13:149-52.
doi: 10.12659/AJCR.883244. Epub 2012 Jul 11.

In situ aortic thrombosis secondary to intra-abdominal abscess

Thomas D Willson  1 , Vijaya Rao, Francis J Podbielski, Matthew J Blecha
Affiliations

In situ aortic thrombosis secondary to intra-abdominal abscess

Thomas D Willson et al. Am J Case Rep. 2012.

Abstract

Background: Abdominal aortic mural thrombus is uncommon in the absence of aneurysm or atherosclerosis.

Case report: We report the case of a 46-year-old man who presented to our institution with perforated appendicitis for which he initially declined surgery. Four days after admission he ultimately consented to appendectomy and abdominal washout. Follow-up imaging to evaluate for intra-abdominal abscess revealed mural thrombus of the infra-renal abdominal aorta extending into the left iliac artery. This thrombus was not present on the admission CT scan. The patient had no clinical signs of limb ischemia. Conservative treatment with therapeutic anticoagulation resulted in resolution of the thrombus.

Conclusions: While portal, mesenteric, and major retroperitoneal venous thrombosis are well associated with major intra-abdominal infection and inflammatory bowel disease, aorto-iliac arterial thrombus formation in the absence of associated aneurysm, atherosclerosis or embolic source is exceedingly rare. We are unaware of other reports of in-situ aorto-iliac arterial thrombus formation secondary to perforated appendicitis.

Keywords: abdominal abscess; aorta; thrombosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A postoperative CT scan revealed an intra-loop abscess as well as new clot in the distal aorta extending to the iliac arteries (A,B). This thrombus was not present on the patient’s admission CT scan.
Figure 2
Figure 2
Arterial Doppler exam revealed normal bilateral triphasic arterial Doppler waveforms and ABI.
Figure 3
Figure 3
At three month follow up, the thrombus had completely resolved.
See this image and copyright information in PMC

References

    1. Gagliardi JM, Batt M, Khodja RH, Le bas P. Mural thrombus of the aorta. Ann Vasc Surg. 1988;2(3):201–4. - PubMed
    1. Hahn TL, Dalsing MC, Sawchuk AP, et al. Primary aortic mural thrombus: presentation and treatment. Ann Vasc Surg. 1999;13(1):52–59. - PubMed
    1. Pousios D, Velissaris T, Duggan S, Tsang G. Floating intra-aortic thrombus presenting as distal arterial embolism. Interact Cardiovascular Thorac Surg. 2009;9(3):532–34. - PubMed
    1. Machleder HI, Takiff H, Lois JF, Holburt E. Aortic mural thrombus: an occult source of arterial thromboembolism. J Vasc Surg. 1986;4(5):473–78. - PubMed
    1. Reber PU, Patel AG, Stauffer E, et al. Mural aortic thrombi: An important cause of peripheral embolization. J Vasc Surg. 1999;30(6):1084–89. - PubMed

LinkOut - more resources