A 12-year-old male presented with an acutely ischaemic leg following a
laparotomy for a pelvic abscess secondary to acute appendicitis, A fe
moral angiogram revealed an embolus at the popliteal artery, Urgent em
bolectomy was performed with restoration of normal arterial flow, Subs
equent investigation revealed a patent foramen ovale, We believe this
case represents a paradoxical embolus from a primary pelvic vein throm
bosis dislodged at the time of laparotomy.