Thoracic aortic thrombosis as a cause of bowel ischemia. A case report

Acute occlusion of the superior mesenteric artery (SMA) is a devastating disease with a high mortality rate. Among its causes is thromboembolism from the heart or from an aortic aneurysm. The authors report a sixty-four-year-old woman who sustained acute occlusion of the SMA from a very large thrombus located on the medial wall of the thoracic aorta, unrelated to an aneurysm. The thrombus was pedunculated and occupied over two thirds of the aortic lumen. Transesophageal echocardiography (TEE) proved to be a valuable tool in diagnosis. The appearance of the thrombus on computed tomographic scan very closely resembled a type B aortic dissection and may have been interpreted as such if the TEE result had not been available.