Cholesterol Crystal Embolism: Autopsy-proven Gastrointestinal Lesions, Pancreatitis, and End-stage Kidney Disease Which Developed after Undergoing Selective Abdominal Angiography

A 78-year-old man with atherosclerosis was diagnosed with hepatocellular carcinoma by transfemoral angiography of the celiac and superior mesenteric arteries (SMA). After surgery, a serum examination revealed progressive renal failure with eosinophilia, leading to end-stage kidney disease, in additi...

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Bibliographic Details
Published in:Internal medicine (Tokyo, 1992) 1992), 2024-12, Vol.63 (24), p.3325
Main Authors: Yamamoto, Naoki, Sakai, Norihiko, Kaikoi, Daichi, Yomogida, Daichi, Kajikawa, Sho, Wada, Takaaki, Yuasa, Takahiro, Ogura, Hisayuki, Sato, Koichi, Miyagawa, Taro, Kitajima, Shinji, Toyama, Tadashi, Hara, Akinori, Shimizu, Miho, Wada, Takashi, Iwata, Yasunori
Format: Article
Language:English
Subjects:
Aged
Angiography
Autopsy
Carcinoma, Hepatocellular - diagnostic imaging
Embolism, Cholesterol - diagnosis
Embolism, Cholesterol - etiology
Fatal Outcome
Humans
Kidney Failure, Chronic - complications
Liver Neoplasms - diagnostic imaging
Male
Mesenteric Artery, Superior - diagnostic imaging
Mesenteric Artery, Superior - pathology
Pancreatitis - diagnostic imaging
Pancreatitis - etiology
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Summary:A 78-year-old man with atherosclerosis was diagnosed with hepatocellular carcinoma by transfemoral angiography of the celiac and superior mesenteric arteries (SMA). After surgery, a serum examination revealed progressive renal failure with eosinophilia, leading to end-stage kidney disease, in addition to active gastric ulcers and pancreatitis. Cyanosis in the bilateral toes showed a cholesterol crystal embolism (CCE) in a skin biopsy. Autopsy revealed that CCE involved the arterioles of multiple organs, and its distribution was anatomically consistent with the vascular territories of the celiac artery and SMA. CCE should therefore be considered in patients presenting with multiple types of tissue damage in the vascular territories after angiography.
ISSN:1349-7235