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Cholesterol embolism causing bleeding gastric ulcers
F A Forouhar1, M Mohit, P Gardner
1Pathology Department, University of Connecticut Health Center, Farmington 06032.
Insights
Atheromatous embolism can cause severe gastric bleeding and ulcers, particularly in elderly men. Surgical intervention is effective for these rare cases, highlighting the need for clinical and pathological awareness.
Area of Science:
- Gastroenterology
- Vascular Pathology
Background:
- Atheromatous embolism is a rare condition where cholesterol plaques break off and travel through the bloodstream.
- Small artery occlusions in the stomach can lead to significant gastrointestinal complications.
Observation:
- Two cases of atheromatous embolism affecting small gastric arteries are presented.
- Both patients experienced severe gastric bleeding and bleeding gastric ulcers identified via endoscopy.
- These are the first reported cases linking this specific embolic event to symptomatic gastric bleeding.
Findings:
- Gastric ulcers in these patients were secondary to arteriolar occlusions caused by atherosclerotic emboli.
- Surgical treatment was successful in both reported cases.
- The pathophysiology of atherosclerotic emboli and their impact on gastric vasculature was discussed.
Implications:
- Clinicians and pathologists should consider atheromatous embolism in elderly males presenting with upper gastrointestinal symptoms like abdominal pain.
- Increased awareness is crucial for accurate diagnosis and timely management of this uncommon condition.
- Understanding this phenomenon aids in differentiating it from more common causes of gastric bleeding.
Abstract:
Two cases of atheromatous embolism of the small arteries of the stomach are reported. Insofar as has been ascertained, they are the first reported cases in the literature which presented symptoms of severe gastric bleeding and were found to have bleeding gastric ulcers on endoscopy. Both patients were successfully treated surgically, and their ulcers were found to be secondary to small arteriolar occlusions owing the atherosclerotic embolization. Awareness of clinicians as well as pathologists of this phenomenon in elderly males with symptoms of abdominal pain and other upper gastrointestinal symptoms unrelated to the ingestion of food is stressed. Pathophysiology of atherosclerotic emboli is also discussed.