Turkish Journal of Geriatrics 2013 , Vol 16, Issue 3
A CASE OF CHOLESTEROL EMBOLISM MIMICKING COLORECTAL CARCINOMA AND LEADING TO OBSTRUCTION IN A GERIATRIC PATIENT
Fahri YETİŞİR1, A. Ebru SALMAN2, Özkan ÖNAL2, Seyid Murat AYDIN1, Mehmet KILIÇ3
1Sağlık Bakanlığı Etlik İhtisas Eğitim ve Araştırma Hastanesi Genel Cerrahi ANKARA
2Sağlık Bakanlığı Ankara Etlik İhtisas Egitim ve Araştırma Hastanesi Anesteziyoloji ve Reanimasyon ANKARA
3Yıldırım Beyazıd Üniversitesi Tıp Fakültesi Genel Cerrahi ANKARA
Cholesterol embolisation syndrome is a rare clinical picture developing as a complication of angiography, vascular surgery, thrombolytic and anticoagulant therapy in patients with atherosclerosis. Its mortality and morbidity is high. It presents with ischemic and painful skin lesions, livedo reticularis and acute renal failure. The variations in clinical presentation make the diagnosis difficult. Gastrointestinal system involvement is in the third rank. There is no definitive treatment option. Since the population under risk for cholesterol embolisation syndrome is increasing, early diagnosis and prevention is gaining importance.

A 73 year old male patient with a body weight of 45 kg was admitted to the hospital with a complaint of inability to defecate. A mass was observed in rectum in colonoscopy. His history revealed hypertension, diabetes, thrombotic aort aneurysm, cigarette smoking, coronary stent application, and use of antiaggregant medication in the past. A low anterior resection was performed for the patient. Pathology results were consistent with cholesterol embolisation syndrome.

In this case report, we probed the diagnosis and treatment of a geriatric case with CES mimicking rectal carcinoma and leading to obstruction. Cholesterol embolisation syndrome should be kept in mind in the differential diagnosis in patients with nonspesific signs related to gastrointestinal system in the presence of risk factors for cholesterol embolisation syndrome. Keywords : Embolism; Cholesterol; Livedo Reticularis; Colorectal Neoplasms