Key result
Surgical resection successfully treated a rare case of spontaneous small intestinal necrosis caused by cholesterol crystal embolization in an 84-year-old man, who remained alive 5 years post-operation.
Case Report (n=1)
No
Cholesterol crystal embolization can spontaneously cause small intestinal necrosis even without iatrogenic risk factors, and should be considered in the differential diagnosis of acute abdomen in elderly men with atherosclerosis.
Alerts clinicians to consider spontaneous cholesterol embolization in elderly atherosclerotic patients with acute abdomen; leaves open optimal diagnostic and management strategies.
症例は高血圧で治療中の84歳の男性で，下腹部痛を主訴に入院した．汎発性腹膜炎の診断で手術を施行したところ，回腸に限局性で，分節，飛び石状の壊死を認めた．病理組織学的検査で，コレステロール結晶塞栓症（cholesterol crystal embolization；以下，CCEと略記）と診断された．CCEは多くの場合，動脈カテーテル検査および処置，血管外科手術，血栓溶解療法あるいは抗凝固療法の後に，微小塞栓によって多臓器の障害を来す予後不良な全身疾患とされている．なかでも腎障害，皮膚障害を引き起こしたとの報告が多く，本症例のように高血圧と動脈硬化以外に医原性危険因子がないにもかかわらず，自然発生的に，突然小腸壊死で発症することは極めてまれである．急性腹症の診断・治療の際，特に高齢の男性の場合には，本症の可能性も念頭に置き対処する必要があると考えられた．
No takes yet. Share an insight, caveat, or question.
Kudo et al. (2012) conducted a case report in Cholesterol crystal embolization (CCE) causing multiple necrosis of the ileum (n=1). Surgical resection of necrotic ileum was evaluated on Patient survival and recovery. Surgical resection successfully treated a rare case of spontaneous small intestinal necrosis caused by cholesterol crystal embolization in an 84-year-old man, who remained alive 5 years post-operation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: