Paradoxical saddle embolus: case report with antemortem diagnosis.

The presence of central right-to-left shunt and paradoxical embolism to the aortic bifurcation was suggested by acute aortic occlusion in a young victim of multiple trauma who had several pulmonary emboli. The diagnosis was confirmed by radionuclide and angiographic means and at operation. Paradoxical embolization should be considered in any individual who suffers simultaneous pulmonary embolism and acute arterial occlusion.