学術雑誌論文 A Case of Cholesterol Crystal Embolization with Hemorrhagic Intestinal Ulcer

YAMATSUJI, Tomoki  ,  YOSHIDA, Kazuhiro  ,  TAMURA, Chiharu  ,  WATANABE, Tatsuya  ,  SAKURAI, Sayaka  ,  ISODA, Ryutaro  ,  MATSUBARA, Masaki  ,  YOSHIDA, Masakazu  ,  ISHIDA, Naomasa  ,  HIRABAYASHI, Yoko  ,  YUKAWA, Takuro  ,  TAKAOKA, Munenori  ,  HAYASHI, Jiro  ,  FUKAZAWA, Takuya  ,  NAKASHIMA, Kazutaka  ,  URAKAMI, Atsushi  ,  MORITA, Ichiro  ,  HAISA, Minoru  ,  KUINOSE, Masahiko  ,  MANO, Masayuki  ,  MONOBE, Yasumasa  ,  NAOMOTO, Yoshio

43 ( 1 )  , pp.29 - 34 , 2017 , Kawasaki Medical Society
ISSN:03850234
NII書誌ID(NCID):AA12685295
内容記述
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 localized intestinal ulcer with active hemorrhage caused by spontaneous CCE. An 83-year-old man with a history of hypertension and diabetes was treated with a percutaneous coronary intervention (PCI) for myocardial infarction. Melena occurred eight days after PCI. An abdominal computed tomography revealed small intestinal ulcer, extravasation of the gastrointestinal tract and bleeding in the abdominal cavity. The patient was diagnosed as bleeding from the small intestinal ulcer, so an emergency laparotomy was performed. Partial resection of the small intestine was performed. A histopathological examination indicated that small intestine obstruction was caused by CCE. A histopathological examination indicated that small intestinal obstruction was caused by CCE. Therefore, in cases of intestinal obstruction after vascular manipulation, CCE should also be considered.
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