Saddle Aortic Embolus With Paraplegia in a 60-Year-Old Diabetic and Hypertensive Patient: A Rare Case of Acute Lower Limb Ischemia

Acute lower limb ischemia (ALI) is a vascular emergency that necessitates prompt intervention to avert irreversible damage. The relationship between ALI and paraplegia is a rare occurrence, particularly in patients with vascular risk factors such as diabetes mellitus (DM) and hypertension (HTN). We present the case of a 60-year-old male with a medical history of DM, HTN, and ischemic heart disease (IHD) who developed acute paraplegia 12 days after undergoing coronary artery bypass grafting (CABG). Initially suspected to have Guillain-Barré syndrome (GBS), further evaluation revealed occlusion of the abdominal aorta and iliac arteries. The patient underwent emergency bilateral fasciotomy and thrombectomy, resulting in partial recovery of lower limb function, with motor and sensory evaluations showing improvement in the right limb but limited recovery in the left. Postoperative complications included acute kidney injury, which was effectively managed. This case highlights the necessity of a broad differential diagnosis for rapidly progressing lower limb paralysis in patients with significant vascular risk factors. Timely diagnosis, prompt intervention, and careful monitoring of outcomes are essential for optimizing results in complex cases of ALI.