Akademik Veri Yönetim Sistemi
5th International Congress On Emergency Medicine “ICON-EM”, Antalya, Türkiye, 27 - 30 Ekim 2025, ss.656, (Özet Bildiri)
Aortic thrombus is a serious vascular condition, typically developing on an atherosclerotic background and potentially leading to systemic embolism. Thrombi in the thoracic aorta without associated aneurysm or atherosclerosis are rare, with few cases reported. Such thrombi can result in widespread organ infarctions and carry high mortality. When multiple organ infarctions are accompanied by acute limb ischemia, urgent multidisciplinary evaluation is crucial. This report highlights a rare case of multisystem embolism originating from a thoracic aortic thrombus, emphasizing the importance of considering this diagnosis in varied clinical presentations.
Case: A 75-year-old female with hypertension, coronary artery disease, and heart failure presented with nausea and leg pain lasting three days. She was only taking acetylsalicylic acid. Her vital signs were stable, but abdominal examination revealed diffuse tenderness. Both lower limbs appeared cyanotic and cold, and the right lower extremity had absent peripheral pulses. Doppler ultrasound confirmed no flow in the femoral artery, suggesting acute arterial occlusion. CT angiography and abdominal imaging showed infarcts in the liver (segment 2), spleen, both kidneys, and signs of mesenteric ischemia. A long segmental occlusion was also present in the right superficial femoral artery. Importantly, a thrombus was detected in the proximal descending thoracic aorta, identified as the embolic source. The patient was hospitalized for emergency surgical intervention following consultation with multiple departments.
Conclusions: Though rare, aortic thrombus can be life-threatening, especially when leading to systemic embolism. It is usually associated with predisposing factors like atherosclerosis or aneurysms. In some cases, small thoracic aortic thrombi may remain asymptomatic until embolic events occur. While isolated embolisms in renal, splenic, mesenteric, or limb arteries have been documented, simultaneous involvement of multiple organ systems is uncommon. In this case, renal, splenic, mesenteric, and lower extremity ischemia were observed due to thoracic aortic thrombus.