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A case report of aortic arch mobile thrombi
  1. E DONAL,
  2. D COISNE,
  3. P CORBI

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A 56 year old woman was admitted with general debility. Diabetes, cachexia, amenorrhoea, combined with the patient's short height, led to a diagnosis of Turner's syndrome. Insulin was administered intravenously to control the diabetes. Reticulonodular shadows were seen in the right inferior lobe on a chest xray. As transthoracic echographic data did not clearly show the aorta, a transoesophageal exam was performed. Two massive thrombi were found protruding into the lumen of the aorta. One was situated in the descending aorta, grinding the contours (left) and appearing to press on the exit of the left subclavian artery. The other was smaller but more mobile (right) and situated in the aortic arch. Left ventricular function was normal, and the heart was in sinus rhythm. No coagulation defect or abnormality of immunity was found, but Turner's syndrome was confirmed by a karyotype. Treatment consisted of a continuous heparin anticoagulation. Ten days after admission, the patient suffered abdominal pain. A further transoesophageal echocardiogram showed the disappearance of both aortic thrombi. After a mesenteric arteriogram, the patient underwent surgical treatment for subacute ischemia of the left colon, caused by superior mesenteric artery thrombosis. Postoperative recovery was uneventful. Six months later the patient was in good health.