Published online Mar 28, 2016. doi: 10.3748/wjg.v22.i12.3502
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
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.