CTICasesMobile Aortic Thrombus with Bowel Ischemia
Imaging findings
CT angiogram shows a mobile, pedunculated thrombus in the descending aorta, along with bowel wall thickening and decreased enhancement in the territory of the superior mesenteric artery, consistent with acute bowel ischemia. Concurrent pulmonary emboli are also present.
Key takeaways
Mobile aortic thrombus in a minimally diseased or non-aneurysmal aorta is a rare source of systemic arterial embolism. It can lead to catastrophic visceral ischemia (e.g., SMA thrombosis) and require urgent anticoagulation or surgical resection.
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