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Case Report
Complete thrombosis of the abdominal aorta in a neonate with advanced lower limbs ischemia: Etiological diagnosis, prognosis, and surgical approach
1 Cardiovascular Surgery Department, Mohammed VI University Hospital, Marrakech, Morocco
2 Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech, Morocco
3 Pediatric Anaesthesia Department, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech, Morocco
Address correspondence to:
Issaka Zallé
Cardiovascular Surgery Department, Mohammed VI University Hospital, Marrakech,
Morocco
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Article ID: 101230Z01YB2021
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Boukaidi Y, Zallé I, El-Alaoui M, Imad N, Thiombiano A, Dicko A, Kane D, Mouaffak Y, Slitine NE, Maoulainine FMR, Boumzebra D. Complete thrombosis of the abdominal aorta in a neonate with advanced lower limbs ischemia: Etiological diagnosis, prognosis, and surgical approach. Int J Case Rep Images 2021;12:101230Z01YB2021.ABSTRACT
Introduction: Neonatal aortic thrombosis is a rare but some cases have been described in the literature. It is associated with high mortality. The main etiology is umbilical vessel catheterization, but others cause coagulopathy, so sepsis could not be excluded. We reported a case of thrombosis of the abdominal aorta at the advanced stage of bilateral lower limbs ischemia treated surgically.
Case Report: At 41-week gestation, a newborn boy was born by vaginal delivery to a 28-year-old gravida II para II mother. He was transferred to the neonatal intensive care unit for neonatal icterus; fever associated with lower limbs’ (extremities’) coldness. Perinatal history was normal. Examination showed cold, cyanotic lower left limb, the right side was a cold, pale with toes necrosis. Bilateral abolition of femoral artery’s pulses, loss of sensibility was found. At the left limb there was mild to moderate motor impairment. No history of umbilical artery catheterization was reported. A contrast computed tomography (CT) scan revealed complete aortoiliac thrombosis. Echocardiogram revealed normal anatomy without intracardiac thrombus. Preoperative blood analysis showed hemostasis anomalies. Cytobacterioligical urine exam was found to be positive for Escherichia coli. The baby underwent aortoiliac thrombectomy via median laparotomy. A surgical procedure was successful with blood flow restoration and limb perfusion. Post-operative blood count showed signs of ischemia-reperfusion, which may cause an unfavorable post-operative survival in our baby.
Conclusion: In conclusion, thrombosis of the aorta in neonates is rare with multiples etiologies. Surgical thrombectomy can be performed uneventfully with the best recanalization of the aorta. Early diagnosis and adequate post-operative management are the determinants of surgical outcomes.
Keywords: Abdominal aorta, Advanced limb ischemia, Ischemia-reperfusion, Neonatal thrombosis, Surgical thrombectomy
SUPPORTING INFORMATION
Author Contributions
Yassine Boukaidi - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Issaka Zallé - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mohamed El-Alaoui - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Najwa Imad - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Abdoulaziz Thiombiano - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Arafaou Dicko - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Djeinaba Kane - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Youssef Mouaffak - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Nadia El Idrissi Slitine - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Fadl Mrabih Rabou Maoulainine - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Drissi Boumzebra - Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Yassine Boukaidi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
