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Eur J Cardiothorac Surg 2002;22:1032-1034
© 2002 Elsevier Science NL

Case report

Possible close relationship between non-occlusive mesenteric ischemia and cholesterol crystal embolism after cardiovascular surgery

^a Department of Cardiovascular Surgery, Saitama Medical School, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
^b Department of Pathology, Saitama Medical School, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan

Received 15 March 2002; received in revised form 17 July 2002; accepted 6 September 2002.

* Corresponding author. Tel.: +81-492-76-1562; fax: +81-492-76-2062
e-mail: imanaka{at}saitama-med.ac.jp

A senile patient developed fatal intestinal necrosis right after uneventful cardiovascular operation using usual cardiopulmonary bypass. Cholesterol crystal embolism (CCE) was demonstrated histologically, but angiograms were typical of non-occlusive mesenteric ischemia (NOMI). Very severe vasoconstriction occurred not only in the superior mesenteric artery but also in other splanchnic arteries. The clinical course strongly suggested that NOMI resulted from CCE and that some humoral factors were released and played very important roles in this case.

Key Words: Cholesterol crystal embolism • Non-occlusive mesenteric ischemia • Intestinal necrosis • Cardiovascular surgery

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