A Case of Acalculous Cholecystitis due to Cholesterol Crystal Embolization

Hirohide Sato, Keiko Nishio, Takahiro Yamazaki, Takeshi Inoue, Iwao Adachi and Shigeho Iida

Department of Surgery, Municipal Tsuruga Hospital

Cholesterol crystal embolization (CCE) is caused by micro showers of cholesterol crystals and has recently been recognized as a serious complication after vascular procedures. An 86-year-old Japanese woman underwent percutaneous coronary artery angioplasty via the right femoral artery. Ten days later, she developed acalculous cholecystitis and was treated by cholecystectomy. Histological exploration of the resected specimen revealed the diagnosis of cholecystitis caused by CCE. Although she could discharge our hospital once after the operation, her renal function began to worsen gradually with eosinophilia and the patient died due to heart failure 6 months after the operation. Although cholesystitis caused by CCE has only rarely been reported, the possible complication of acalculous cholecystitis caused by cholesterol crystal embolization must be borne in mind. The diagnosis of cholesterol crystal embolization after routine cholecystectomy suggests severe systemic involvement and a poor prognosis.

Key words
cholesterol crystal, embolization, cholecystitis

Reprint requests
Hirohide Sato Department of Surgery, Municipal Tsuruga Hospital
1-6-60 Mishima, Tsuruga, 914-8502 JAPAN

Accepted
February 28, 2007

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