Acute aortic occlusion (AAO) is an uncommon but potentially devastating vascular emergency with reported perioperative mortality rates of up to 75%. We present the case of AAO in a 69-year-old woman who was transferred to our institution after presenting with sudden onset bilateral acute limb ischaemia. Imaging showed a completely obstructed aortoiliac segment with renal infarcts. She was treated successfully with aortoiliac over the wire thrombectomy.
Acute aortic occlusion is an emergent vascular condition not encountered routinely. Given its varied presentations, including neurovascular deficits and mimicking an acute abdomen, the diagnosis is often delayed causing increased morbidity and mortality. We present a case of acute abdominal aortic occlusion masquerading as sudden onset lower extremity pain and weakness in an 86-year-old female requiring emergent thrombectomy. This is only the second case report to discuss the use of point-of-care ultrasound to expedite diagnosis and management.
A 67-year-old male known to be hypertensive and diabetic had a sudden onset of severe low back pain and flaccid paraplegia with no sensory level or bladder affection and the distal pulsations were felt. Acute compressive myelopathy was excluded by MRI of the dorsal and lumbar spines. The nerve conduction study and CSF analysis was suggestive of acute demyelinating polyneuropathy. The patient developed ischemic changes of the lower limb and CT angiography revealed severe stenosis of the abdominal aorta and both common iliac arteries. We emphasize the importance of including acute aortic occlusion in the differential diagnosis of acute flaccid paraplegia especially in the presence of severe back pain even if the distal pulsations were felt.
Sudden-Onset Paraplegia and Ischemia of the Lower Extremities from Acute Aortic Occlusion following Type A Acute Dissection