Acute thrombotic disorders

Catastrophic antiphospholipid antibody syndrome presenting as acute vascular occlusion in a young female patient

Acquired thrombotic and thromboembolic disorders may be presented initially with symptoms and signs of acute ischaemia or organ dysfunction that will lead many of these patients to seek care in the emergency department. We report a case of a 19-year-old female patient who developed catastrophic antiphospholipid syndrome (CAPS syndrome or Asherson syndrome) 6 weeks post stillbirth with an initial presentation of acute vascular occlusion. The patient was immediately operated and anticoagulated with significant improvement.

Evaluation of imaging quality of pulmonary 64-MDCT angiography in pregnancy and puerperium

OBJECTIVE

The aim of this study was to quantitatively and qualitatively evaluate pulmonary 64-MDCT angiography image quality in pregnancy and puerperium, compared with female nonpregnant control subjects.

MATERIALS AND METHODS

The study group comprised 124 consecutive pregnant and postpartum women and 124 female nonpregnant control subjects who presented with suspected pulmonary embolism. The individual studies were evaluated for subjective and objective diagnostic quality.

RESULTS

Objective measurements of the arterial enhancement in the pulmonary trunk and left and right pulmonary arteries found that there was no statistically significant difference in attenuation values between the pregnant and puerperium group and the control group for pulmonary artery opacification. The mean attenuation in the pulmonary trunk was 270.54 HU in the pregnant group, 277.53 HU in the puerperium group, and 293.90 HU in the control group.

CONCLUSION

We found no significant difference in diagnostic quality of pulmonary CT angiography using MDCT between the study and control groups. The use of MDCT acquisition, faster injection rates, higher contrast medium concentration, and higher trigger levels may decrease the number of nondiagnostic studies in this population. MDCT may be a worthwhile investigation in the majority of pregnant patients with suspected pulmonary embolism.

Acute infrarenal aortic thrombosis presenting with flaccid paraplegia

STUDY DESIGN

This study is a case report.

OBJECTIVE

To report a case of a patient with paraplegia and low back pain, who was diagnosed with acute infrarenal aortic thrombosis.

SUMMARY OF BACKGROUND DATA

There have been few reports in the literature regarding acute aortic thrombosis presenting with paraplegia.

METHODS

A 56-year-old man was referred to our emergency department with flaccid paraplegia and low back pain. Clinical examination and imaging revealed acute infrarenal aortic thrombosis, with lower limb ischemia. The patient underwent transcutaneous embolectomy.

RESULTS

Despite successful revascularization, the patient finally died because of development of revascularization syndrome.

CONCLUSION

Acute aortic occlusion is a catastrophic event and may present with paraplegia, because of acute spinal cord ischemia. This can mislead the clinician to a wrong diagnosis and delay initiation of definite treatment.