A case report of atrial fibrillation with abdominal aortic embolism mimicking acute myelitis

Rationale: The most common complication of atrial fibrillation is cerebral embolism, while abdominal aortic embolism is relatively rare. This case highlights the need for heightened clinical awareness of systemic embolic complications associated with atrial fibrillation. Patient concerns: A 76-year-old male patient presented with sudden onset of bilateral lower limb weakness lasting 12 hours, accompanied by numbness and pain in both legs. Symptoms have persisted without improvement and are associated with gross hematuria. Diagnoses: Computed tomography angiography of the chest and abdomen reveals occlusion of the lower abdominal aorta (below the renal arteries) and bilateral lower extremity arteries; thrombus formation in the descending aorta; incidental findings of low-density areas in both renal parenchyma. Interventions: Administer enoxaparin for anticoagulation. Recommend transferring the patient to an intensive care unit or a higher-level hospital for treatment. The patient and their family are aware of the associated risks and have declined further treatment. Outcomes: During a subsequent follow-up phone call, it was reported that the patient had passed away. Lessons: This case demonstrates that complications of atrial fibrillation are not limited to common cerebral embolism; embolism involving other organs can also be fatal.