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Clinical communication| Volume 10, ISSUE 2, P139-145, March 1992

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Acute abdominal aortic occlusion

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      Abstract

      Acute occlusion of the infrarenal abdominal aorta is a catastrophic event requiring early recognition and intervention if permanent disability is to be decreased or avoided. While traditional causes of occlusion (saddle embolus and thrombosis) are the most frequent, vasculitis and hypercoagulable states have recently been suggested as etiologies. This article presents three cases of acute abdominal aortic occlusion from different mechanisms and reviews the literature concerning presentation and management.

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      References

        • Perry M.O.
        Acute arterial insufficiency of the extremities.
        in: Rutheford R.B. Vascular surgery. 2nd ed. WB Saunders, Philadelphia1984: 440-448
        • Smith G.J.
        • Holcroft J.W.
        • Blaisdell F.W.
        Acute arterial insufficiency.
        in: Wilson S.E. Veith F.J. Hobson R.W. Williams R.A. Vascular surgery-principles and practice. McGraw-Hill, New York1987: 325-331
        • Spencer F.C.
        • Eiseman B.
        Delayed arterial embolectomy: a new concept.
        Surgery. 1964; 55: 64-72
        • Busuttil R.W.
        • Keehn G.
        • Milliken J.
        • et al.
        Aortic saddle embolus: a twenty-year experience.
        Ann Surg. 1983; 197: 698-706
        • Parkes A.R.
        Traumatic ischemia of peripheral nerves with some observations on Volkmann's ischemic contracture.
        Br J Surg. 1945; 32: 403-414
        • Mozingo J.R.
        • Denton I.C.
        The neurological deficit associated with sudden occlusion of abdominal aorta due to blunt trauma.
        Surgery. 1975; 77: 118-125
        • Adams H.D.
        • Greertruyden H.H.
        Neurologic complications of aortic surgery.
        Ann Surg. 1956; 144: 574-610
        • Eames F.A.
        • Robeson G.H.
        Angiography of the spine.
        in: Kadir S. Diagnostic angiography. WB Saunders, Philadelphia1986: 496-509
        • Djindjian R.
        Angiography of the spinal cord.
        Surg Neurol. 1974; 2: 179-185
        • Anderson N.E.
        • Willoughby E.W.
        Infarction of the conus medullaris.
        Ann Neurol. 1987; 21: 470-474
        • Dommisse G.F.
        The arteries and veins of the human spinal cord from birth.
        Churchill Livingstone, Edinburgh1975
        • Fauré C.
        • Lefebvre J.
        • Debrun G.
        • Djindjian R.
        La vascularisation artérielle normale et pathologique du renflement lombaire de la moelle épiniére chez l'enfant: L'artére D'Adamkiewicz.
        Ann Radiol. 1967; 10: 129-140
        • Dickson A.P.
        • Lum S.K.
        • Whyte A.S.
        Paraplegia following saddle embolism.
        Br J Surg. 1984; 71: 321
        • Haimovici H.
        Arterial embolism of the extremities and technique of embolectomy.
        in: Haimovici H. Haimovici's vascular surgery: principles and techniques. 3rd ed. Appleton and Lange, Norwalk, Connecticut1989: 330-353
        • Thompson J.E.
        • Weston A.S.
        • Sigler L.
        • Raut P.S.
        • Austin D.J.
        • Patman R.D.
        Arterial embolectomy after acute myocardial infarction: a study of 31 patients.
        Ann Surg. 1970; 171: 979-986
        • Arvan S.
        Mural thrombi in coronary artery disease: recent advances in pathogenesis, diagnosis, and approaches to treatment.
        Arch Intern Med. 1984; 144: 113-116
        • Santiani B.
        • Gross W.S.
        • Evans W.E.
        Improved limb salvage after arterial embolectomy.
        Ann Surg. 1978; 188: 153-157
        • Littooy F.N.
        • Baker W.H.
        Acute aortic occlusion — a multifaceted catastrophe.
        J Vasc Surg. 1986; 4: 211-216
        • Reeder G.S.
        • Tajik A.J.
        • Seward J.B.
        Left ventricular mural thrombus: two-dimensional echocardiographic diagnosis.
        in: 3rd ed. Mayo Clin Proc. 56. 1981: 82-86 (2)
        • Ports T.A.
        • Cogan J.
        • Schiller N.B.
        • Rapaport E.
        Echocardiography of left ventricular masses.
        Circulation. 1978; 58: 528-536
        • Haimovici H.
        • Escher D.J.W.
        Aortoiliac stenosis: diagnostic significance of vascular hemodynamics.
        Arch Surg. 1956; 72: 107-117
        • Haimovici H.
        Acute arterial thrombosis.
        in: Haimovici H. Haimovici's vascular surgery: principles and techniques. 3rd ed. Appleton and Lange, Norwalk, Connecticut1989: 354-360
        • Schafer A.I.
        The hypercoagulable states.
        Ann Intern Med. 1985; 102: 814-828
        • Gruber H.E.
        • Weisman M.H.
        Aortic thrombosis during sigmoidoscopy in Behçet's syndrome.
        Arch Intern Med. 1983; 143: 34335
        • King D.J.
        • Kelton J.G.
        Heparin-associated thrombocytopenia.
        Ann Intern Med. 1984; 100: 535-540
        • Shapiro M.E.
        • Rodvien R.
        • Bauer K.A.
        • Salzman E.W.
        Acute aortic thrombosis in antithrombin III deficiency.
        JAMA. 1981; 245: 1759-1761
        • Lanham J.G.
        • Levin M.
        • Brown Z.
        • Gharavi A.E.
        • Thomas P.A.
        • Hanson G.C.
        Prostacyclin deficiency in a young woman with recurrent thrombosis.
        Br Med J. 1986; 292: 435-436
        • Drew P.
        • Asherson R.A.
        • Zuk R.J.
        • Goodwin F.J.
        • Hughes G.R.V.
        Aortic occlusion in systemic lupus erythematosus associated with antiphospholipid antibodies.
        Ann Rheum Dis. 1987; 46: 612-616
        • Cervantes J.
        • Martinez R.
        • Perez-Garcia D.
        Acute thrombosis of abdominal aortic aneurysm.
        J Cardiovasc Surg. 1985; 26: 598-601
        • Lee K.R.
        • Walls W.J.
        • Martin N.L.
        A practical approach to the diagnosis of abdominal aortic aneurysms.
        Surgery. 1975; 78: 195-201
        • Bluth El.
        Ultrasound of the abdominal aorta.
        Arch Intern Med. 1984; 144: 377-380
        • Godwin J.D.
        • Korobkin M.
        Acute disease of the aorta: diagnosis by computed tomography and ultrasonography.
        Radiol Clin North Am. 1983; 21: 551-574
        • Drager S.B.
        • Riles T.S.
        • Imparato A.M.
        Management of acute aortic occlusion.
        Am J Surg. 1979; 138: 293-295
        • Rosen S.A.
        Painless aortic dissection presenting as spinal cord ischemia.
        Ann Emerg Med. 1988; : 17
      1. Ann Emerg Med. 1988; : 840-842
        • Conrad M.R.
        • Davis G.M.
        • Green C.E.
        • et al.
        Real time ultrasound in the diagnosis of acute dissecting aneurysm of the abdominal aorta.
        AJR. 1979; 132: 115-116
        • Gerber O.
        • Heyer E.J.
        Painless dissections of the aorta presenting as acute neurologic syndromes.
        Stroke. 1986; 17: 644-647
        • Adler J.
        • Robey G.
        Acute aorto-iliac thrombosis in a young man shown on unenhanced computed tomography.
        Br J Radiol. 1989; 62: 627-628
        • Weston T.S.
        • Ardagh J.W.
        Infrarenal dissection of the aorta.
        N Z Med J. 1975; 82: 302-304
        • Sutton D.
        Arteriography in the diagnosis of dissecting aneurysm.
        Clin Radiol. 1960; 11: 85-92
        • Kirshner R.L.
        • Green R.M.
        Acute thrombosis of abdominal aortic aneurysm subsequent to Heimlich maneuver: A case report.
        J Vasc Surg. 1985; 2: 594-596
        • Welborn M.B.
        • Sawyers J.L.
        Acute abdominal aortic occlusion due to nonpenetrating trauma.
        Am J Surg. 1969; 118: 112-116
        • Nunn D.B.
        Abdominal aortic dissection following nonpenetrating abdominal trauma.
        Am Surg. 1973; 39: 177-179
        • Angel R.T.
        • Crosthwait R.W.
        Acute traumatic dissecting aneurysm of the abdominal aorta.
        Tex Med. 1972; 68: 82-85
        • Borja A.R.
        • Lansing A.M.
        Thrombosis of the abdominal aorta caused by blunt trauma.
        J Trauma. 1970; 10: 499-501
        • Sumpio B.E.
        • Gusberg R.J.
        Aortic thrombosis with paraplegia: an unusual consequence of blunt abdominal trauma.
        J Vasc Surg. 1987; 6: 412-414
        • Dajee H.
        • Richardson I.W.
        • Iype M.O.
        Seat belt aorta: acute dissection and thrombosis of the abdominal aorta.
        Surgery. 1979; 85: 263-267
        • David D.
        • Blumenberg R.M.
        Subintimal aortic dissection with occlusion after blunt abdominal trauma.
        Arch Surg. 1970; 100: 302-304
        • Hewitt R.L.
        • Grablowsky O.M.
        Acute traumatic dissecting aneurysm of the abdominal aorta.
        Ann Surg. 1970; 171: 160-162
        • Macbeth A.
        • Malone J.M.
        • Norton L.W.
        • Peltier L.F.
        Paralysis and aortic thrombosis following blunt abdominal trauma.
        J Trauma. 1982; 22: 591-594
        • Ngu V.A.
        • Konstam P.G.
        Traumatic dissecting aneurysm of the abdominal aorta.
        Br J Surg. 1965; 52: 981-982
        • Mangiante E.C.
        • Voeller G.R.
        • Kidsk K.A.
        • Fabian T.C.
        Blunt injury of the abdominal aorta.
        J Ten Med Assoc. 1989; 82: 255-256
        • Thal E.R.
        • Perry M.O.
        • Crighton J.
        Traumatic abdominal aortic acclusion.
        South Med J. 1971; 64: 653-656
        • Rybak J.J.
        • Thomford N.R.
        Acute occlusion of the infrarenal aorta from blunt trauma.
        Am Surg. 1969; 35: 444-447
        • Kleinert H.E.
        • Romero J.
        Blunt abdominal trauma: review of cases admitted to a general hospital over a 10 year period.
        J Trauma. 1961; 1: 226-240
        • Tomatis L.A.
        • Doornbos F.A.
        • Beard J.A.
        Circumferential intimal tear of aorta with complete occlusion due to blunt trauma.
        J Trauma. 1968; 8: 1096-1101
        • Potter D.J.
        • Hopkins J.G.
        Reversible paraplegia and acute renal failure due to occlusive disease of the abdominal aorta.
        Ann Intern Med. 1968; 69: 777-780
        • Blute R.
        • Ray F.
        Traumatic dissecting aneurysm of the abdominal aorta.
        J Maine Med Assoc. 1973; 64: 164-166
        • Van Reedt Dorland R.W.H.
        • Clevers G.J.
        Crush accident resulting in isolated abdominal aortic injury.
        Neth J Surg. 1988; 40: 108-109
        • Haimovici H.
        Metabolic complications of acute arterial occlusion and related conditions: role of free radical (myonephropathic-metabolic syndrome).
        in: Haimovici H. Haimovici's vascular surgery. 3rd ed. Appleton and Lange, Norwalk, Connecticut1989: 386-408
        • Porter J.M.
        • Acinapura A.J.
        • Silver D.
        Aortic saddle embolectomy.
        Arch Surg. 1966; 93: 360-364
        • Gordon R.D.
        • Fogarty T.J.
        Peripheral arterial embolism.
        in: Rutherford R.B. Vascular surgery. 2nd ed. WB Saunders, Philadelphia1984: 449-459
        • LeBlanc J.G.
        • Culham J.A.G.
        • Chan K.W.
        • et al.
        Treatment of grafts and major vessel thrombosis with low-dose streptokinase in children.
        Ann Thorac Surg. 1986; 41: 630-635