下行大動脈浮遊血栓の1例

Floating Thrombus in Descending Aorta；Report of a Case

はじめに　下行大動脈の浮遊血栓という非常にまれな疾患を経験したので，若干の文献的考察を加えて報告する．

We report a very rare case of floating thrombus in the thoracic descending aorta （TDA）. A 54-year-old man complaining of severe lower abdominal pain was admitted to our facility. Enhanced computed tomography demonstrated a filling defect in the TDA, embolism of the superior mesenteric artery （SMA）， and bilateral renal infarction. Transesophageal echocardiography revealed that the mass in the TDA was pedunculated, floating, and multiple with maximal diameter of 30 mm. To avoid bowel necrosis, we proceeded with emergent thrombectomy of the SMA. The TDA, including the mass, was removed en bloc for diagnostic confirmation and replaced with prosthesis under cardiopulmonary bypass for prevention of recurrent embolism. The postoperative course was uneventful. On histological examination, the mass proved to be a blood clot on the atherosclerotic wall. No recurrent thrombosis was observed during the 1-year follow-up period.