{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T21:03:12Z","timestamp":1763154192856,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/jcm14093092","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T05:50:17Z","timestamp":1745992217000},"page":"3092","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?\u2014A Case Report and a Review of Literature"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5822-8805","authenticated-orcid":false,"given":"Lauren\u021biu Augustus","family":"Barbu","sequence":"first","affiliation":[{"name":"Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolae-Drago\u0219","family":"M\u0103rg\u0103ritescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8232-3457","authenticated-orcid":false,"given":"Liliana","family":"Cercelaru","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel-Cosmin","family":"Caragea","sequence":"additional","affiliation":[{"name":"Departament of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ionic\u0103-Daniel","family":"V\u00eelcea","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-5408","authenticated-orcid":false,"given":"Valeriu","family":"\u0218urlin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stelian-\u0218tefani\u021b\u0103","family":"Mogoant\u0103","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Florin R\u0103zvan","family":"Mogo\u0219","sequence":"additional","affiliation":[{"name":"Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7018-5675","authenticated-orcid":false,"given":"Liviu","family":"Vasile","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiberiu \u0218tef\u0103ni\u021b\u0103","family":"\u021aenea Cojan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rare\u015f Street, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1067\/mva.2002.120373","article-title":"Contemporary management of acute mesenteric ischemia: Factors associated with survival","volume":"35","author":"Park","year":"2002","journal-title":"J. Vasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/S0741-5214(94)70155-5","article-title":"Mesenteric venous thrombosis: Still a lethal disease in the 1990s","volume":"20","author":"Rhee","year":"1994","journal-title":"J. Vasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/BF02000672","article-title":"The role of intravenous fluorescein in the detection of colon ischemia during aortic reconstruction","volume":"6","author":"Bergman","year":"1992","journal-title":"Ann. Vasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7302","DOI":"10.3748\/wjg.14.7302","article-title":"Ischemic colitis: Clinical practice in diagnosis and treatment","volume":"14","author":"Theodoropoulou","year":"2008","journal-title":"World J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/00004836-199809000-00004","article-title":"Colonic ischemia","volume":"27","author":"Greenwald","year":"1998","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1002\/jgh3.12612","article-title":"Clinical characteristics of ulcerative colitis in elderly patients","volume":"5","author":"Zhu","year":"2021","journal-title":"JGH Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1053\/j.gastro.2011.10.001","article-title":"Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review","volume":"142","author":"Molodecky","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1016\/j.cgh.2020.02.048","article-title":"Progression of Elderly Onset Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis of Population-Based Cohort Studies","volume":"18","author":"Rozich","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1002\/ibd.20628","article-title":"Inflammatory bowel disease in the elderly is associated with worse outcomes: A national study of hospitalizations","volume":"15","author":"Ananthakrishnan","year":"2009","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.cgh.2010.09.026","article-title":"Advanced age is an independent risk factor for severe infections and mortality in patients given anti-tumor necrosis factor therapy for inflammatory bowel disease","volume":"9","author":"Cottone","year":"2011","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1093\/ecco-jcc\/jjaa181","article-title":"Epidemiology and Natural History of Elderly-onset Inflammatory Bowel Disease: Results from a Territory-wide Hong Kong IBD Registry","volume":"15","author":"Mak","year":"2021","journal-title":"J. Crohns Colitis"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100106","DOI":"10.1016\/j.jvssci.2023.100106","article-title":"Thrombosis in the pathogenesis of abdominal aortic aneurysm","volume":"4","author":"Bontekoe","year":"2023","journal-title":"JVS Vasc. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.jvir.2011.01.454","article-title":"Imaging the intraluminal thrombus of abdominal aortic aneurysms: Techniques, findings, and clinical implications","volume":"22","author":"Labruto","year":"2011","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/S1078-5884(98)80031-2","article-title":"Biomechanics of abdominal aortic aneurysm in the presence of endoluminal thrombus: Experimental characterisation and structural static computational analysis","volume":"15","author":"Mantero","year":"1998","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2848","DOI":"10.1161\/CIRCULATIONAHA.110.014902","article-title":"Predictors of abdominal aortic aneurysm sac enlargement after endovascular repair","volume":"123","author":"Schanzer","year":"2011","journal-title":"Circulation"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.ejvs.2020.02.011","article-title":"Total Luminal Volume Predicts Risk after Endovascular Aneurysm Repair","volume":"59","author":"Ferreira","year":"2020","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e000126","DOI":"10.1136\/tsaco-2017-000126","article-title":"Predictive factors of mortality after colectomy in ischemic colitis: An ACS-NSQIP database study","volume":"2","author":"Tseng","year":"2017","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jviscsurg.2013.01.002","article-title":"Ischemic colitis: The ABCs of diagnosis and surgical management","volume":"150","author":"Moszkowicz","year":"2013","journal-title":"J. Visc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.amjsurg.2005.09.018","article-title":"Ischemic colitis","volume":"192","author":"Huguier","year":"2006","journal-title":"Am. J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.cgh.2009.05.026","article-title":"Epidemiology, clinical features, high-risk factors, and outcome of acute large bowel ischemia","volume":"7","author":"Longstreth","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.amjsurg.2010.07.005","article-title":"Ischemic colitis: Risk factors for eventual surgery","volume":"200","author":"Paterno","year":"2010","journal-title":"Am. J. Surg."},{"key":"ref_22","first-page":"4875","article-title":"Factors predicting poor prognosis in ischemic colitis","volume":"12","author":"Sanchiz","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/01.SMJ.0000145399.35851.10","article-title":"Ischemic colitis: A clinical review","volume":"98","author":"Green","year":"2005","journal-title":"South. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1111\/j.1572-0241.2007.01260.x","article-title":"Pharmacologically mediated colon ischemia","volume":"102","author":"Hass","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_25","unstructured":"Blanc, P., Bories, P., Donadio, D., Parelon, G., Rouanet, C., Paleirac, G., and Michel, H. (1989). Ischemic colitis and recurrent venous thrombosis caused by familial protein S deficiency. Gastroenterol. Clin. Biol., 13."},{"key":"ref_26","first-page":"1350","article-title":"Colite isch\u00e9mique due \u00e0 un d\u00e9ficit en prot\u00e9ine S [Ischemic colitis caused by protein S deficiency]","volume":"25","author":"Verger","year":"1996","journal-title":"Presse Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1023\/A:1010788532195","article-title":"Ischemic colitis, pulmonary embolism, and right atrial thrombosis in a patient with inherited resistance to activated protein C","volume":"43","author":"Ludwig","year":"1998","journal-title":"Dig. Dis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"595","DOI":"10.7326\/0003-4819-132-7-200004040-00027","article-title":"Ischemic colitis associated with factor V Leiden mutation","volume":"132","author":"Yee","year":"2000","journal-title":"Ann. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1023\/A:1018867311839","article-title":"Prothrombin 20210G\/A mutation in two patients with mesenteric ischemia","volume":"44","author":"Balian","year":"1999","journal-title":"Dig. Dis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.semarthrit.2006.09.003","article-title":"Catastrophic Antiphospholipid Syndrome (CAPS) Registry Project Group. Intestinal involvement secondary to the antiphospholipid syndrome (APS): Clinical and immunologic characteristics of 97 patients: Comparison of classic and catastrophic APS","volume":"36","author":"Cervera","year":"2007","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1023\/A:1025441405688","article-title":"Low plasma protein Z levels in patients with ischemic colitis","volume":"48","author":"Koutroubakis","year":"2003","journal-title":"Dig. Dis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1053\/gast.2001.27227","article-title":"Role of acquired and hereditary thrombotic risk factors in colon ischemia of ambulatory patients","volume":"121","author":"Koutroubakis","year":"2001","journal-title":"Gastroenterology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.cgh.2008.03.010","article-title":"Genetic risk factors in young patients with ischemic colitis","volume":"6","author":"Theodoropoulou","year":"2008","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1097\/01.SMJ.0000066655.54770.88","article-title":"Ischemic colitis revisited: A prospective study identifying hypercoagulability as a risk factor","volume":"97","author":"Polen","year":"2004","journal-title":"South. Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"920","DOI":"10.3949\/ccjm.70.11.920","article-title":"Investigation and management of ischemic colitis","volume":"70","author":"Baixauli","year":"2003","journal-title":"Cleve Clin. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0039-6109(16)45635-5","article-title":"Colonic ischemia","volume":"72","author":"Brandt","year":"1992","journal-title":"Surg. Clin. N. Am."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/BF02048275","article-title":"Ischemic colitis","volume":"39","author":"Gandhi","year":"1996","journal-title":"Dis. Colon Rectum"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1007\/BF02050319","article-title":"Ischemic colitis: Patterns and prognosis","volume":"35","author":"Longo","year":"1992","journal-title":"Dis. Colon Rectum"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s10350-003-0033-6","article-title":"Outcome of patients with ischemic colitis: Review of fifty-three cases","volume":"47","author":"Medina","year":"2004","journal-title":"Dis. Colon Rectum"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"117","DOI":"10.47162\/RJME.62.1.11","article-title":"Pathological and immunohistochemical study of colon cancer. Evaluation of markers for colon cancer stem cells","volume":"62","author":"Ilie","year":"2021","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1016\/j.jvs.2015.01.040","article-title":"Low wall shear stress predominates at sites of abdominal aortic aneurysm rupture","volume":"63","author":"Boyd","year":"2016","journal-title":"J. Vasc. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1098\/rsif.2011.0041","article-title":"Blood flow and coherent vortices in the normal and aneurysmatic aortas: A fluid dynamical approach to intra-luminal thrombus formation","volume":"8","author":"Biasetti","year":"2011","journal-title":"J. R. Soc. Interface"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s10439-009-9843-6","article-title":"Hemodynamics of the normal aorta compared to fusiform and saccular abdominal aortic aneurysms with emphasis on a potential thrombus formation mechanism","volume":"38","author":"Biasetti","year":"2010","journal-title":"Ann. Biomed. Eng."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"472564","DOI":"10.1155\/2013\/472564","article-title":"CFD modelling of abdominal aortic aneurysm on hemodynamic loads using a realistic geometry with CT","volume":"2013","author":"Soudah","year":"2013","journal-title":"Comput. Math. Methods Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1161\/01.ATV.17.4.646","article-title":"Shear-induced platelet activation and platelet microparticle formation at blood flow conditions as in arteries with a severe stenosis","volume":"17","author":"Holme","year":"1997","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1182\/blood-2006-04-011551","article-title":"Activation-independent platelet adhesion and aggregation under elevated shear stress","volume":"108","author":"Ruggeri","year":"2006","journal-title":"Blood"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1161\/01.RES.0000267878.97021.ab","article-title":"Adhesion mechanisms in platelet function","volume":"100","author":"Ruggeri","year":"2007","journal-title":"Circ. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1182\/blood-2006-07-028282","article-title":"Identification of a 2-stage platelet aggregation process mediating shear-dependent thrombus formation","volume":"109","author":"Maxwell","year":"2007","journal-title":"Blood"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1111\/j.1572-0241.2003.07483.x","article-title":"Cardiac sources of embolism should be routinely screened in ischemic colitis","volume":"98","author":"Bouin","year":"2003","journal-title":"Am. J. Gastroenterol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1111\/j.1572-0241.1998.00328.x","article-title":"The immunohistological diagnosis of E. coli O157:H7 colitis: Possible association with colonic ischemia","volume":"93","author":"Su","year":"1998","journal-title":"Am. J. Gastroenterol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3092\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:24:31Z","timestamp":1760030671000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,29]]},"references-count":50,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14093092"],"URL":"https:\/\/doi.org\/10.3390\/jcm14093092","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,4,29]]}}}