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Cholesterol Embolization Syndrome From Penetrating Aortic Ulcer
- Source :
- Cureus
- Publication Year :
- 2020
- Publisher :
- Cureus, 2020.
-
Abstract
- Penetrating aortic ulcer (PAU) is an important, albeit, rarer cause of embolization to internal organs and distal extremities. Embolization occurs as a result of the disruption of cholesterol deposition in the wall of the aorta by a PAU. The classic presentation of cholesterol embolization syndrome (CES) includes pain, pallor, poikilothermia, paresthesia, and paralysis with intact pulses. The patient will classically have livedo reticularis or "blue toes." We present a case of a patient who presented to the emergency department with the complaint of a painful, blue toe. The patient had intact distal pulses on exam with the distal 2/3 of the first toe having a markedly blue/black color with livedo reticularis spreading proximally on the other 1/3 of the toe. CT angiogram with runoff to the lower extremities revealed a 3.6-cm infrarenal abdominal aortic aneurysm with a 5-mm penetrating aortic ulcer with a three-vessel runoff to the distal lower extremities. The diagnosis of CES secondary to a PAU was made. While thrombotic embolization from PAU causing acute limb ischemia is less common, it is well described. In contrast, cholesterol embolization from PAU remains a rare phenomenon without adequate treatment options.
- Subjects :
- medicine.medical_specialty
Blue Toe Syndrome
medicine.medical_treatment
cholesterol embolism syndrome
Cardiology
cholesterol crystals
030204 cardiovascular system & hematology
Pallor
03 medical and health sciences
0302 clinical medicine
medicine.artery
Paralysis
Internal Medicine
Medicine
blue toe syndrome
Cholesterol embolization syndrome
Embolization
Livedo reticularis
Aorta
business.industry
General Engineering
medicine.disease
acute aortic syndromes
Abdominal aortic aneurysm
Surgery
body regions
Cardiac/Thoracic/Vascular Surgery
penetrating aortic ulcer
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 21688184
- Volume :
- 12
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Cureus
- Accession number :
- edsair.doi.dedup.....b1c8b56342e0b840d2e866df86c83cfe