Acute Paraplegia Revealing Leriche Syndrome

Abstract

This 61-year-old-man with a past history of heavy smoking and ischemic stroke was admitted to the emergency department because of acute non-traumatic paraplegia. At admission, he was in good clinical condition. Complete para-plegia of both legs was accompanied by sensory loss below the T10-level. Patellar and Achilles tendon reflexes were reduced bilaterally. An emergency contrast-enhanced CT-scan showed no spinal lesions but a thrombotic occlusion of the subrenal abdominal aorta was visible (arrows) and the left kidney was poorly perfused (Picture 1, 2). Rapidly, the clinical situation deteriorated and his legs were cool with absent distal peripheral pulses in both lower extremities. Despite urgent embolectomy through bifemoral arteriotomies the patient developed refractory shock with multiorgan failure. He died 2 days later in the intensive care unit.