Thrombosis of the Aorta Abdominalis in Infants - Diagnosis and Thrombolytic Therapy

Background: Aortic thrombosis is rarely observed in neonates and infants. Underlying conditions include the presence of umbilical artery catheters, thrombosed aneurysm of the ductus arteriosus, sepsis and different states of inherited thrombophilia. Treatment options include anticoagulation, thrombolytic therapy and thrombectomy. Due to the lack of large studies, neither diagnosis nor treatment of neonatal aortic thrombosis are standardized. Patients: From 2008-2010, 1 neonate and 1 infant were admitted to our hospital with symptomatic aortic thrombosis. Methods and Results: In both patients, diagnosis was made by Doppler ultrasound. Both patients were effectively treated with recombinant tissuetype plasminogen activator. Diagnosis and treatment of 2 infants with symptomatic aortic thrombosis are discussed and the literature is reviewed. Conclusions: Since aortic thrombosis is a life-threatening condition, early diagnosis by Doppler ultrasound is mandatory to initiate treatment without delay. Thrombolytic therapy is a safe measure to treat this condition if administered with caution and if the patient has not suffered from serious complications such as mesenteric infarction or renal failure prior to begin of therapy.