Key result
Emergency bowel resection fails to prevent death from cholesterol crystal embolization causing multiple perforations.
Why the study?
Cholesterol crystal embolization (CCE) is a rare systemic embolic disease that can cause gastrointestinal symptoms, but progression to gastrointestinal perforation is uncommon.
Case Report (n=1)
Highlights a rare and fatal case of multiple small bowel perforations caused by cholesterol crystal embolization.
Multiple small bowel perforations may complicate cholesterol crystal embolization with high mortality; leaves open optimal prevention and management strategies.
コレステロール塞栓症（cholesterol crystal embolization:CCE）は血管内粥腫の破綻， 飛散による稀な全身性塞栓症である．症例:77歳，男性．腹部激痛があり当院搬送．腹膜刺激症状を認め，CT上free airと腹水を認め消化管穿孔の診断で緊急手術となった．小腸3箇所に穿孔部を認め小腸部分切除施行．病理組織所見でCCEによる小腸多発潰瘍穿孔の診断．術後3日目に胃管より黒色排液があり，上部消化管内視鏡にて胃・十二指腸にも多発潰瘍を認めた．術後4日目にドレーンより腸液様排液があり小腸再穿孔が疑われたが，術後より意識障害と痙攣重積があり，頭部CTで多発脳梗塞が確認されていたため再開腹術は断念し，術後8日目に死亡した．CCEの症状は，腎機能障害・皮膚症状・消化管症状などがあるが消化管穿孔に至ることは稀である．CCEによる消化管穿孔について過去の症例を踏まえ報告する．
No takes yet. Share an insight, caveat, or question.
Tsukumo et al. (2014) conducted a case report in Cholesterol crystal embolization with multiple small bowel perforations (n=1). Cholesterol crystal embolization was evaluated on Clinical outcome. A 77-year-old man with cholesterol crystal embolization developed multiple small bowel perforations and died on the eighth postoperative day despite emergency partial resection of the small intestine.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: