Neonatal Spontaneous Abdominal Aortic Thrombosis Associated With Hypernatremic Dehydration and Acute Renal Failure: A Case Series

Spontaneous abdominal aortic thrombosis in neonates due to various causes is a known entity. Hypernatremic dehydration with acute kidney injury/failure can also be one of the aetiologies. A 14- and 11-day-old term neonate born to primigravida mothers presented to two different facilities with a similar presentation of hypernatremic dehydration and acute kidney injury/failure attributed to inadequate breastfeeding causing non-catheter-related spontaneous abdominal aortic thrombosis. In both cases, initial management was supportive care, fluids and electrolyte corrections, antibiotics, and antihypertensives. Anticoagulant therapy resulted in notable improvement in renal function and general well-being of the neonates. A high index of suspicion of vascular thrombosis in neonates presenting with hypernatremic dehydration and acute renal injury/failure is key to having good clinical outcomes. Newer anticoagulant drugs like rivaroxaban can be promising in the management of neonatal aortic thrombosis.