Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature

Barbu, Laurențiu Augustus; Mărgăritescu, Nicolae-Dragoș; Cercelaru, Liliana; Caragea, Daniel-Cosmin; Vîlcea, Ionică-Daniel; Șurlin, Valeriu; Mogoantă, Stelian-Ștefaniță; Mogoș, Gabriel Florin Răzvan; Vasile, Liviu; Țenea Cojan, Tiberiu Ștefăniță

doi:10.3390/jcm14093092

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Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature

by

Laurențiu Augustus Barbu

¹

,

Nicolae-Dragoș Mărgăritescu

^2,*,

Liliana Cercelaru

³

,

Daniel-Cosmin Caragea

⁴,

Ionică-Daniel Vîlcea

²,

Valeriu Șurlin

²

,

Stelian-Ștefaniță Mogoantă

²,

Gabriel Florin Răzvan Mogoș

¹,

Liviu Vasile

²

and

Tiberiu Ștefăniță Țenea Cojan

¹

Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rareş Street, 200349 Craiova, Romania

²

Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rareş Street, 200349 Craiova, Romania

³

Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania

⁴

Departament of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2025, 14(9), 3092; https://doi.org/10.3390/jcm14093092 (registering DOI)

Submission received: 21 March 2025 / Revised: 27 April 2025 / Accepted: 28 April 2025 / Published: 29 April 2025

(This article belongs to the Special Issue Colon and Rectal Surgery: Current Clinical Practice and Future Trends)

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Abstract

Background/Objectives: Ischemic colitis, typically caused by thrombosis or reduced blood flow in the inferior mesenteric artery, is the most common ischemic lesion at the colorectal level. This case contributes to existing knowledge by highlighting the rare co-occurrence of a thrombosed aortic aneurysm and ischemic colitis, pointing to a direct vascular etiology rather than a multifactorial or idiopathic cause. Methods: A thorough electronic search was conducted on PubMed to identify risk factors and etiological determinants of ischemic colitis. Results: We present the case of a 70-year-old male with diffuse abdominal pain and multiple cardiac comorbidities. A CT scan revealed aeroenteritis, aerocolia, fusiform aneurysmal dilation of the abdominal aorta (18 cm long, 7.3 cm in diameter, from below the renal arteries to the bifurcation), parietal thrombosis, a circulating lumen of 2.7 cm, and inferior mesenteric artery thrombosis. Intraoperatively, necrosis was found in the upper rectum, sigmoid colon, descending colon, and the middle third of the left transverse colon, with clear demarcation between healthy and necrotic tissue. A subtotal proctocolectomy with transverse colostomy was performed. Conclusions: This case highlights ischemic colitis as a vascular disorder, urging broader differential diagnosis when common causes are unclear. Timely imaging, a multidisciplinary approach, and attention to vascular risks are key to identifying rare causes like aneurysmal thrombosis. While thrombosed abdominal aortic aneurysms can cause mesenteric ischemia, their link to ischemic and ulcerative colitis is unique, emphasizing the importance of accurate risk assessment in treatment planning.

Keywords: ischemic colitis; abdominal aortic aneurysms; inferior mesenteric artery thrombosis

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MDPI and ACS Style

Barbu, L.A.; Mărgăritescu, N.-D.; Cercelaru, L.; Caragea, D.-C.; Vîlcea, I.-D.; Șurlin, V.; Mogoantă, S.-Ș.; Mogoș, G.F.R.; Vasile, L.; Țenea Cojan, T.Ș. Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature. J. Clin. Med. 2025, 14, 3092. https://doi.org/10.3390/jcm14093092

AMA Style

Barbu LA, Mărgăritescu N-D, Cercelaru L, Caragea D-C, Vîlcea I-D, Șurlin V, Mogoantă S-Ș, Mogoș GFR, Vasile L, Țenea Cojan TȘ. Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature. Journal of Clinical Medicine. 2025; 14(9):3092. https://doi.org/10.3390/jcm14093092

Chicago/Turabian Style

Barbu, Laurențiu Augustus, Nicolae-Dragoș Mărgăritescu, Liliana Cercelaru, Daniel-Cosmin Caragea, Ionică-Daniel Vîlcea, Valeriu Șurlin, Stelian-Ștefaniță Mogoantă, Gabriel Florin Răzvan Mogoș, Liviu Vasile, and Tiberiu Ștefăniță Țenea Cojan. 2025. "Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature" Journal of Clinical Medicine 14, no. 9: 3092. https://doi.org/10.3390/jcm14093092

APA Style

Barbu, L. A., Mărgăritescu, N.-D., Cercelaru, L., Caragea, D.-C., Vîlcea, I.-D., Șurlin, V., Mogoantă, S.-Ș., Mogoș, G. F. R., Vasile, L., & Țenea Cojan, T. Ș. (2025). Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature. Journal of Clinical Medicine, 14(9), 3092. https://doi.org/10.3390/jcm14093092

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Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?—A Case Report and a Review of Literature

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