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Updated: Aug 13, 2026
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Perforation of the small bowel: a case report
Summary
Cholesterol emboli caused a rare jejunal perforation 8 weeks after streptokinase therapy for myocardial infarction. This syndrome also presented with renal failure and toe ischemia, confirmed by renal biopsy.
Area of Science:
- Gastroenterology
- Cardiology
- Nephrology
Background:
- Nontraumatic small bowel perforation is an uncommon clinical event.
- Cholesterol embolization syndrome (CES) is a rare complication associated with procedures like angiography, vascular surgery, and thrombolytic therapy for myocardial infarction.
Observation:
- A 71-year-old male experienced jejunal perforation 8 weeks post-streptokinase therapy for myocardial infarction.
- The patient presented with multiple systemic complications including a bleeding duodenal ulcer, acute renal failure, digital ischemia, and confusion.
- Renal biopsy revealed cholesterol emboli, and the resected jejunal specimen also showed extensive cholesterol embolization.
Findings:
- The patient's jejunal perforation was directly attributed to cholesterol emboli.
- The clinical presentation of renal failure and digital ischemia is consistent with established manifestations of CES.
Implications:
- This case highlights a rare but serious gastrointestinal complication of cholesterol embolization syndrome.
- It underscores the importance of considering CES in patients with systemic embolic events following cardiovascular interventions.
- Early recognition and management of CES may be crucial to prevent severe organ damage.
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