Primary aortic thrombosis.

T HROMBOSIS of the terminal aorta, insidious in onset and progress, is not uncommon. Since 1940 the clinical picture has been made clear, largely owing to the comnunications of Leriche and Morel.' The clinical features originally described by Leriche were (1) in the male, inability to maintain a stable erection because of a reduced blood flow through the internal pudendal arteries; (2) extreme fatigability of the lower limbs when walking or standing; (3) generalized atrophy of muscles in both buttocks and in both lower limbs; (4) absence of nutritional changes of the skin and pallor of the feet when the patient was standing. Since then it has been recognized that claudication of the calf muscles is the usual presenting symptom an(l that nutritional changes proceeding to gangrene may occur. Most cases of aortic occlusion occur in males in the fifth and sixth decades, but the condition has been reported in patients as young as 29 years.2 In the vast majority of instances the thrombosis is secondary to atherosclerosis or embolism. Less commonly, thrombosis may oceur ill the sae of an anieuirysm of either the dissecting or saccular type and has followed syphilitic aortitis,3 pressure by tumors,4 pelvic peritonitis, and irradiation to the abdomen. The following description of a ease of aortic thrombosis occurring in a young adult man is of interest becaluse the throinl)osis was prinmary in origin, a rare event.