Azuma S, Ikenouchi M, Akamatsu T, Seta T, Urai S, Uenoyama Y, Yamashita Y. Ileus caused by cholesterol crystal embolization: A case report. World J Gastroenterol 2016; 22(12): 3502-3505 [PMID: 27022232 DOI: 10.3748/wjg.v22.i12.3502]
Corresponding Author of This Article
Shunjiro Azuma, MD, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, 4-20 Komatsubaradori, Wakayama-city, Wakayama 640-8558, Japan. aaazzzuuummmaaa1984@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan
Author contributions: Azuma S designed the report; Azuma S, Ikenouchi M, Akamatsu T, Seta T, Urai S, Uenoyama Y and Yamashita Y were the attending doctors; and Azuma S wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Japan Red Cross Society Wakayama Medical Center Institutional Review Board.
Informed consent statement: The authors provided oral informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest associated with this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shunjiro Azuma, MD, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, 4-20 Komatsubaradori, Wakayama-city, Wakayama 640-8558, Japan. aaazzzuuummmaaa1984@gmail.com
Telephone: +81-73-4224171 Fax: +81-73-4261168
Received: November 13, 2015 Peer-review started: November 13, 2015 First decision: November 27, 2015 Revised: December 9, 2015 Accepted: December 30, 2015 Article in press: December 30, 2015 Published online: March 28, 2016 Processing time: 131 Days and 8.6 Hours
Abstract
Cholesterol crystal embolization (CCE) is a rare systemic embolism caused by formation of cholesterol crystals from atherosclerotic plaques. CCE usually occurs during vascular manipulation, such as vascular surgery or endovascular catheter manipulation, or due to anticoagulation or thrombolytic therapy. We report a rare case of intestinal obstruction caused by spontaneous CCE. An 81-year-old man with a history of hypertension was admitted for complaints of abdominal pain, bloating, and anorexia persisting for 4 mo. An abdominal computed tomography revealed intestinal ileus. His symptoms were immediately relieved by an ileus tube insertion, and he was discharged 6 d later. However, these symptoms immediately reappeared and persisted, and partial resection of the small intestine was performed. A histopathological examination indicated that small intestine obstruction was caused by CCE. At the 12-mo follow-up, the patient showed no evidence of CCE recurrence. Thus, in cases of intestinal obstruction, CCE should also be considered.
Core tip: Cholesterol crystal embolization (CCE) is a rare systemic embolism caused by formation of cholesterol crystals from atherosclerotic plaques. This case report details a rare case that was not only a spontaneous occurrence but also caused a focal intestinal lesion. CCE usually carries a serious prognosis, but this case had a good prognosis.
