A Large Discrepancy between Oral versus Rectal Temperatures as an Early Warning Sign in a Patient with Acute Infrarenal Aortic Occlusion

Abstract

Background: Acute aortic occlusion is a rare condition that requires early diagnosis to help prevent considerable morbidity and mortality. Typical clinical findings, such as acute lower extremity pain, acute paralysis, and absent pedal pulses, may be masked by a variety of underlying medical conditions.

Case report: We present a patient with altered mental status, hypothermia, and a large discrepancy between oral and rectal temperature measurements, who was ultimately diagnosed with aortic occlusion. This case report describes a marked difference between oral and rectal temperatures in a case of acute aortic occlusion. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Acute aortic occlusion is a true vascular emergency that, without early intervention, can lead to limb ischemia, bowel necrosis, paralysis, or death. Emergency physicians should consider acute aortic occlusion in a patient with a marked difference between oral and rectal temperature measurements who otherwise has a limited clinical evaluation.

Keywords: acute aortic occlusion; hypothermia; temperature; vascular emergencies.