DOI: 10.36347/sjmcr.2018.v06i08.017

Pages: 552-555

Thrombus in the aorta is frequently associated with aortic atherosclerosis in patients with cardiovascular risk factors. However, a thrombus in the aorta not related to aneurysm or atherosclerosis is a rare clinical entity with a limited number of cases reported. The treatment remains an object of controversy. Herein, we report the case of a 55-year-old woman who presented with an acute intestinal occlusion due to a small bowel tumor which revealed to be malign in the anatomopathology exam. The patient underwent surgery with a tumor resection and a double stoma. The surgical outcomes were characterized with a left lower limb critical ischemia. A computed tomography scan angiography showed a floating thrombus of the sub renal abdominal aorta. Thus, an embolectomy was performed and an anticoagulating treatment introduced, with a great outcome. While conservative medical treatment certainly represents a cornerstone of primary approach in asymptomatic patients, management becomes demanding in presence of symptoms or distal embolism. A few cases have shown that a conservative approach with anticoagulants represents a viable option. However Moris et al. suggested that the strategy should be chosen based on peculiar characteristics of thrombus like its location, mobility, morphology, persistence of symptoms under anticoagulants and high risk of recurrence.