title: Cholesterol atheroembolism of the colon can mimic the endoscopic features of pseudomembranous colitis.
abstract: The endoscopic features of cholesterol atheroembolism affecting the colon have not been extensively described in the literature, owing to the rarity of this entity. We report a middle-aged man who presented with hematochezia after recent coronary artery bypass graft surgery. Colonoscopy revealed ulcerative skip lesions with overlying slough resembling pseudomembranes distal to the transverse colon, inconsistent with the initial clinical impression of ischemic colitis. As a consequence of continued bleeding with hemodynamic instability, the patient underwent an extended low anterior resection with end transverse colostomy. Histology revealed cholesterol atheroembolism resulting in patchy ischemic ulceration of the colon. Colonic cholesterol atheroembolism can mimic the endoscopic features of pseudomembranous colitis.
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, University of Malaya, Singapore.
authors.forename: Geok-Hoon
authors.initials: GH
authors.lastname: Lim
authors.forename: April Camilla
authors.initials: AC
authors.lastname: Roslani
authors.forename: Brendan
authors.initials: B
authors.lastname: Pang
authors.forename: Charles Tsang
authors.initials: CT
authors.lastname: Bih-Shiou
mesh_terms: D044466:Asian People; D003082:Colectomy; D017091:Colitis, Ischemic / Q000175:diagnosis* / Q000209:etiology; D003106:Colon / Q000473:pathology / Q000601:surgery; D003125:Colostomy; D003937:Diagnosis, Differential; D017700:Embolism, Cholesterol / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D016145:Endoscopy, Digestive System; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011350:Proctocolitis / Q000175:diagnosis