Cholesterol crystal embolization is a well-known disorder resulting from re
lease of cholesterol crystals from ulcered atherosclerotic plaques. Gastroi
ntestinal involvement occurs in about a third of cases, but it is usually a
symtomatic. We report a case of an old woman with small bowel obstruction s
econdary to atheromatous embolism. She was treated by acenocoumarol for atr
ial fibrillation and pulmonary embolism. Two weeks before admission for sma
ll bowel obstruction, she had a watery diarrhea. After 3 weeks of parentera
l nutrition, she underwent resection of the involved ileum. Pathological ex
amination showed a small bowel stricture secondary to atheromatous embolism
. Cholesterol emboli should be considered as a potential cause of small bow
el obstruction in old patient who has taken anticoagulant therapy or after
vascular invasive procedure.