Acil Servise Yürüyerek Giren Bir Hastada Total Abdominal Aort Oklüzyonu Tanısı

Abstract

Giriş: Tromboz riski hiperkoagülabilite durumlarında artar. Hiperkoagülabilite, kalıtsal veya kazanılmış olabilir. Burada; acil servise yürüyerek giren, kalıtsal hiperkoagülabilitesi olan ve acil serviste total abdominal aort oklüzyonu ile akut renal arter trombozu tanısı konan bir olgu sunacağız. Olgu Sunumu: 48 yaşında bayan hasta, 30 dakika önce başlayan sağ yan ağrısı şikayetiyle acil servise başvurdu. Ağrı aniden başlamıştı ve sürekli karakterdeydi. Hasta acil servise acil servise yürüyerek girdi. Kontrastlı batın bilgisayarlı tomografisinde; sağ renal enfarkt, sağ renal arter trombüsü ve iliak arter bifurkasyonu seviyesinde abdominal aortta trombüs tespit edildi. Sonuç: Abdominal aort oklüzyonu, hiperkoagülabilitenin nadir görülen komplikasyonlarından biridir. Abdominal aortanın total oklüzyonu, genellikle alt ekstremitelerde iskeminin kardinal bulguları ile kendini gösterir. Bizim vakamızda, gelişmiş kollateral akım sayesinde alt ekstremitelerde kan akımının azalmasına bağlı bulgu tespit edilmemiştir. Acil servise yürüyerek giren bir hastanın, total aort oklüzyonu tanısı alması acil servis hekimleri açısından ilginç bir durumdur.

Keywords

• Tromboz, abdominal aort, renal enfarkt

A Diagnosis of Total Abdominal Aortic Occlusion in a Patient Who Entered the Emergency Department by Walking

Abstract

Introduction: The risk of thrombosis is increased in hypercoagulability. Hypercoagulability can be inherited or acquired. Here, we want to present a patient with inherited hypercoagulability who came to the emergency department by walking and was diagnosed with total abdominal aortic thrombosis and acute renal artery thrombosis.Case Report: A 48-year-old female patient presented to our emergency medicine department with a history of right flank pain for 30 minutes. The pain had started abruptly and was continuous. She came to the emergency medicine department by walking. The contrast-enhanced abdominal computed tomography showed right renal infarction, right artery occlusion, and abdominal aortic thrombus at the level of the iliac bifurcation.Conclusion: Abdominal aortic thrombus is a relatively rare complication of hypercoagulability. Total occlusion of the aorta is generally presented with pain, pallor, weakness, and numbness of the lower limbs. In our case, there was none of these signs due to the blood flow supplied by collaterals. It is a challenge to diagnose total aortic occlusion in a patient that comes to the emergency department by walking

Keywords

• Thrombosis, abdominal aorta, renal infarction

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