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Case Report
Umbilical artery catheterization a cause of abdominal aortic thrombosis in neonates: A case report
1 Children’s Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
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El Bakkari Asaad
Children’s Hospital, Ibn Sina Hospital, Mohamed V University, Rabat,
Morocco
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Article ID: 101037Z01EA2019
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Asaad EB, Ayouche O, Yassine S, Youssef D, Najlaa S, Allali N, Chat L. Umbilical artery catheterization a cause of abdominal aortic thrombosis in neonates: A case report. Int J Case Rep Images 2019;10:101037Z01EA2019.ABSTRACT
Introduction: Aortic thromboembolism is relatively common among patients following cardiovascular procedures and trauma. The abdominal aorta is the most common site for thrombosis, especially its distal portion. Based on the Virchow triad, thrombosis is caused by an imbalance among endothelium, blood flow, and coagulation. Inherited or acquired hypercoagulable states play a key role in thrombus formation in both the arteria and venous system. Elevated levels of C-reactive protein, homocysteine and lipoprotein (a) are more likely to be involved with arterial thrombus. Antiphospholipid antibodies are associated with both venous and arterial thromboembolic events. The advent of new radiologic modalities, with more noninvasive techniques, has allowed for early diagnostics and treatment of these entities, in neonatal population.
Case Report: We report the case of five days newborn, with a sepsis history due to foeto-maternal infection, who needed an umbilical catheter for monitoring. Three days later, he presented with distal ischemia an abolition of femoral artery pulses in front of that we conducted a Doppler ultrasound (US) and a computed tomography (CT) angiography, which demonstrated an inframesenteric aorta thrombosis which extended to the iliac axes. No surgery was necessary, and an anti-thrombin 2019 treatment was conducted. No complications were noted in follow-up exams.
Conclusion: Radiologists should keep in mind that abdominal aortic thrombosis, even if it is a rare entity, could complicate many conditions altering the Virchow triad. Arterial thrombosis is often due to a parietal mechanism, for example, umbilical catheters. Sonography is the modality of choice for first line diagnosis in neonates. Contrast-enhanced CT is recommended for the diagnosis of pseudo-occlusion and determines the treatment choice.
Keywords: Aortic thrombosis, Computed tomography, Newborn, Ultrasound, Umbilical
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Author Contributions
El Bakkari Asaad - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Othman Ayouche - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Smiti Yassine - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Dahbi Youssef - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Salmi Najlaa - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nazik Allali - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Latifa Chat - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 El Bakkari Asaad 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.
