Acute Aortic Thrombosis Following Anterior Resection - A Rare Complication

Introduction: Anterior resection is a commonly performed surgery for rectal cancer worldwide. It is associated with a wide spectrum of complications that include hemorrhage, pelvic sepsis, wound infection, anastomotic breakdown, deep vein thrombosis, peripheral nerve injury, impotence and urological dysfunction. However acute aortic thrombosis post-anterior resection is a very rare complication. Case Presentation: We report a rare case of aortic thrombosis in a 67-year-old gentleman following anterior resection for rectal cancer. Discussion: We discuss the possible causes as there are many postulations regarding the etiology of this devastating complication. Prolonged surgery, abnormal blood coagulation in a cancer patient, the lithotomy position, and the presence of peripheral vascular disease were predisposing factors contributing to this rare acute aortic thrombosis in our patient. A standard routine neurovascular examination of the extremities should be done in the postoperative period to help detect early any neurovascular complications. The use of prophylactic anticoagulants such as fondaparinux, low molecular weight heparin, or low dose unfractionated heparin is strongly recommended in high-risk surgery patients undergoing a major surgery, helping in the prevention of thromboembolic episodes following surgery.