Thoracoabdominal aortic mural and floating thrombus extending into superior mesenteric artery

Thrombus in the thoracic aorta not related to aneurysm or atherosclerosis is a rare clinical entity with a limited number of cases reported. Floating thrombus is defined as non-adherent part of the thrombus floating within the aortic lumen. Herein, we present a 48-year-old woman who presented with progressive midline dull, aching abdominal pain of 2-day duration. Thoracoabdominal computed tomography revealed a free floating thrombus extending from the aortic arch into the superior mesenteric artery. Transesophageal echocardiography confirmed the findings of a thrombus extending through the aortic arch. Floating thrombus within the aortic lumen in a morphologically normal descending thoracic and abdominal aorta is a rare entity.