Mesenteric ischemia and distal atheroembolism due to penetrating aortic ulcer: case report

Abstract

Introduction: Penetrating Aortic Ulcer (PAU) is characterized by the formation of an ulcerated atherosclerotic plaque that can embolize and generate important acute vascular events, due to obstruction and ischemia of internal organs and occlusion of vessels in the extremities. Therefore, the mesenteric ischemia is one of the causes of vascular acute abdomen, generated by the abrupt interruption of the blood supply to the abdominal organs. Distal atheroembolism, on the other hand, refers to mechanical arterial obstruction due to a cholesterol embolus leading to acute ischemia, generating a clinical picture of pain and cyanosis, which can lead to necrosis of the affected limb Objective: To relate PAU with atheroembolic events, such as mesenteric ischemia and distal atheroembolism. Case report: A 64-year-old female patient with consecutive diagnoses of acute vascular abdomen due to mesenteric ischemia and distal atheroembolism of the left hallux, both secondary to PAU. Conclusion: Although rare, the hypothesis of aortic PU as a cause of atheroembolic events cannot be underestimated and, despite its challenging management, its early suspicion helps to minimize complications.