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

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.