PERFORATION OF THE SMALL-BOWEL - A CASE-REPORT

Nontraumatic perforation of the small bowel is rare. A 71-year-old man presented with a perforated jejunum 8 weeks after receiving streptoki nase therapy for acute myocardial infarction. This was complicated by a bleeding duodenal ulcer, renal failure, ischemia of one toe and conf usion. Renal biopsy showed cholesterol emboli. Examination of the rese cted specimen of jejunum revealed multiple cholesterol emboli but no o ther disorder. Cholesterol embolization has been associated with angio graphy, vascular surgery and thrombolytic therapy for myocardial infar ction. Acute renal failure and ischemia of the digits as seen in this patient is also a common presentation of cholesterol embolization synd rome.