Acute supramesenteric thrombosis of an abdominal aortic aneurysm with deleterious embolism: a case report

A 55-year-old man was admitted with severe pain, paralysis of both legs and absent femoral pulses. Computed tomographic scan demonstrated a 6 cm juxtarenal abdominal aortic aneurysm (AAA) with thrombosis starting at the level of the celiac trunk. At immediate operation, thrombectomy of visceral arteries was performed and distal neovascularization was achieved with a bifurcated prosthesis. It was revealed that all major arteries were occluded with debris. Embolectomy did restore flow in major vessels, but organ perfusion was not achieved due to occlusion of smaller vessels. The patient died with multiorgan failure. This is the first description in the literature of an acutely thrombosed AAA at the supramesenteric level.