[Small bowel obstruction secondary to ischemic stenosis due to cholesterol crystal embolism]

Cholesterol crystal embolization is a well-known disorder resulting from release of cholesterol crystals from ulcerous atherosclerotic plaques. Gastrointestinal involvement occurs in about a third of cases, but it is usually asymptomatic. We report a case of an old woman with small bowel obstruction secondary to atheromatous embolism. She was treated by acenocoumarol for atrial fibrillation and pulmonary embolism. Two weeks before admission for small bowel obstruction, she had a watery diarrhea. After 3 weeks of parenteral nutrition, she underwent resection of the involved ileum. Pathological examination showed a small bowel stricture secondary to atheromatous embolism. Cholesterol emboli should be considered as a potential cause of small bowel obstruction in old patient who has taken anticoagulant therapy or after vascular invasive procedure.