title: Ileus caused by cholesterol crystal embolization: A case report.
abstract: 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 intestinal obstruction caused by spontaneous CCE. An 81-year-old man with a history of hypertension was admitted for complaints of abdominal pain, bloating, and anorexia persisting for 4 mo. An abdominal computed tomography revealed intestinal ileus. His symptoms were immediately relieved by an ileus tube insertion, and he was discharged 6 d later. However, these symptoms immediately reappeared and persisted, and partial resection of the small intestine was performed. A histopathological examination indicated that small intestine obstruction was caused by CCE. At the 12-mo follow-up, the patient showed no evidence of CCE recurrence. Thus, in cases of intestinal obstruction, CCE should also be considered.
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Shunjiro
authors.initials: S
authors.lastname: Azuma
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Ikenouchi
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Akamatsu
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Seta
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Urai
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Uenoyama
authors.affiliation: Shunjiro Azuma, Maiko Ikenouchi, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology, Japan Red Cross Society Wakayama Medical Center, Wakayama-city, Wakayama 640-8558, Japan.
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002784:Cholesterol / Q000097:blood*; D003460:Crystallization; D017700:Embolism, Cholesterol / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D045823:Ileus / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D011237:Predictive Value of Tests; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002784:Cholesterol
keywords: Catheter manipulation; Cholesterol crystal embolization; Ileus; Intestinal obstruction; Vascular manipulation