Lim Geok-Hoon, Roslani April Camilla, Pang Brendan, Bih-Shiou Charles Tsang
Division of Colorectal Surgery, Department of Surgery, University of Malaya, Singapore.
Surg Laparosc Endosc Percutan Tech. 2008 Dec;18(6):616-8. doi: 10.1097/SLE.0b013e318180c956.
The endoscopic features of cholesterol atheroembolism affecting the colon have not been extensively described in the literature, owing to the rarity of this entity. We report a middle-aged man who presented with hematochezia after recent coronary artery bypass graft surgery. Colonoscopy revealed ulcerative skip lesions with overlying slough resembling pseudomembranes distal to the transverse colon, inconsistent with the initial clinical impression of ischemic colitis. As a consequence of continued bleeding with hemodynamic instability, the patient underwent an extended low anterior resection with end transverse colostomy. Histology revealed cholesterol atheroembolism resulting in patchy ischemic ulceration of the colon. Colonic cholesterol atheroembolism can mimic the endoscopic features of pseudomembranous colitis.
由于胆固醇性动脉粥样硬化栓塞累及结肠这一情况较为罕见，其内镜特征在文献中尚未得到广泛描述。我们报告了一名中年男性，他在近期冠状动脉搭桥手术后出现便血。结肠镜检查发现横结肠远端有溃疡性跳跃性病变，其上覆有类似假膜的脱落物，这与缺血性结肠炎的初始临床印象不符。由于持续出血且血流动力学不稳定，患者接受了扩大的低位前切除术并进行了横结肠末端造口术。组织学检查显示胆固醇性动脉粥样硬化栓塞导致结肠出现斑片状缺血性溃疡。结肠胆固醇性动脉粥样硬化栓塞可模仿假膜性结肠炎的内镜特征。
