A case of anastomotic stenosis of the small intestine caused by cholesterol crystal embolism
نویسندگان
چکیده
BACKGROUND Cholesterol crystal embolism (CCE) is caused by small crystals of cholesterol dispersed from atherosclerotic plaques of the aorta. There is an increasing interest in CCE because of the increased use of endovascular treatments. Here, we report a rare case of intestinal stenosis caused by CCE after functional end-to-end anastomosis (FEEA). To our knowledge, this is the first report of CCE causing such an anastomotic stenosis. CASE PRESENTATION A 77-year-old male patient underwent laparoscopy-assisted low anterior resection and protective ileostomy for rectal carcinoid tumor. He was admitted to our hospital with ileus 1 year after stoma closure. Eosinophils and creatine kinase level were slightly elevated. Computed tomography revealed a stricture with thickened intestinal wall just distal to the anastomosis site of the ileostomy. The wall of the descending aorta appeared shaggy due to thrombosis. The patient underwent laparoscopic small-bowel resection because ileus reoccurred after any oral intake. Histopathological findings of the resected specimen showed fibrotic changes distal to the anastomosis site, and needle-shaped cholesterol embolus was observed in the submucosal layer. Thus, the stenosis was considered to be caused by CCE. CONCLUSION This appears to be the first published report of stenosis due to CCE at such an anastomotic site. Intestinal CCE is difficult to diagnose preoperatively and is associated with poor prognosis. If eosinophilia is present or shaggy aorta is observed, CCE should be suspected to make correct diagnosis and prevent recurrence of CCE.
منابع مشابه
Congenital Esophageal Stenosis Associated with Esophageal Atresia and Gasless Abdomen
SUMMARY A radiologically gasless abdomen in a neonate with EA is usually regarded as being pathognomonic of an absence of distal T.E.F. It has been estimated that up to 1.5% of patient with a distal fistula may have a radiologically gasless abdomens as a manifestation of a very small fistula plugged with mucus. In this case a contrast study via the gastrostomy demonstrated a fistula between th...
متن کاملThe association between small dense low density lipoprotein,apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio and coronary artery stenosis
Abstract Background: Recently, small dense low density lipoprotein (sdLDL) has been highlighted as a new risk factor for the coronary artery disease (CAD).Small dense LDLs are believed to be atherogenic since these particles are taken up more easily by arterial wall. They are readily oxidized and have reduced affinity for low density lipoprotein (LDL) receptor and increased affinity...
متن کاملگانگرن کامل روده باریک ناشی از آمبولی سپتیک شریان مزانتریک سوپریور در شیرخوار 16 ماهه
Abstract Background: Thrombo-embolism occurs due to a lot of different etiologies and has a high rate of mortality. But septic embolus is a very uncommon type of embolism and this patient is reported as a septic mesenteric embolism. Case Report: A 16 month patients was referred to the hospital with signs and symptoms of intestinal obstruction and septicemia. After clinical and Para-clinical eva...
متن کاملMITRAL STENOSIS COMPLICATED BY RENAL ARTERY EMBOLISM
Six patients with mitral stenosis complicated by renal artery embolism studied prospectively are presented. In five patients there was unilateral and in one patient bilateral renal artery involvement. The diagnosis was confirmed by intravenous pyelography, retrograde pyelography, renal angiography, renal scan or a combination of these. All had atrial fibrillation, proteinuria and elevated ...
متن کاملجایگزینی مری در کودکان و معرفی 18 مورد از بیمارستان حضرت علیاصغر(ع)
Background & Aim: Esophageal replacement is done for patients with long gap esophageal atresia, severe stenosis of esophagus due to gastroesophageal reflux, and burns due to chemical agents. A suitable replacement for esophagus must have the following qualities: appropriate function, no tendency to malignancy, straight direction, no gastroesophageal reflux, and fewer complications. Today ga...
متن کامل