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Liu S, Tong Y, Shi R, Zeng X, Luo H, Yang P, Cai X, Wang D, Luo H, Wang J. Case report and literature review: Laparoscopic extended right hemicolectomy for a 55-year-old patient with idiopathic mesenteric phlebosclerosis. Front Med (Lausanne) 2024; 11:1382475. [PMID: 39081687 PMCID: PMC11286469 DOI: 10.3389/fmed.2024.1382475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/28/2024] [Indexed: 08/02/2024] Open
Abstract
Idiopathic mesenteric phlebosclerosis (IMP) is an extremely rare disease with an unclear pathogenesis and risk factors. The clinical manifestations of IMP are mostly non-specific, mainly consisting of digestive symptoms such as abdominal pain, bloating and diarrhea. The diagnosis of IMP mainly relies on abdominal computed tomography (CT) and colonoscopy. Pathological changes associated with IMP often involve fibrous degeneration of the venous wall, which results in the thickening of the colonic wall and longitudinal calcification of the mesenteric arteries. Currently, there is no standard treatment protocol for IMP, and nonsurgical treatment is the mainstay of most medical centers. In this study, we reported a case of a 55-year-old female patient with IMP whose main clinical presentation was recurrent abdominal pain. The patient's initial diagnosis was considered an incomplete intestinal obstruction and received non-surgical treatments; however, the efficacy of the treatment was unsatisfactory. After completing abdominal CT and colonoscopy, we excluded common diseases of the digestive system (e.g., tumors, Crohn's disease), and finally considered that this patient had a high likelihood of IMP. This patient eventually underwent laparoscopic enlarged right hemicolectomy due to recurrent symptoms and poor outcomes of non-surgical treatment. Postoperative pathological results confirmed the diagnosis of IMP. During the follow-up period, the patient recovered well without recurrence of IMP. Furthermore, we have reviewed the literature related to IMP and summarized the etiology, risk factors, diagnostic methods, treatment options and prognosis of IMP.
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Affiliation(s)
- Siyu Liu
- Department of Breast Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Yujun Tong
- Department of Breast Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Ruizi Shi
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Xintao Zeng
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Hua Luo
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Pei Yang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Xianfu Cai
- Department of Urology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Decai Wang
- Department of Urology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Huiwen Luo
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Jianjun Wang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
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Wang PY, Weng KH, Liou JY, Kuo HT, Ho CH, Sheu MJ. Clinical significance of abdominal computed tomography and colonoscopy in the evaluation of phlebosclerotic colitis. Kaohsiung J Med Sci 2024; 40:296-303. [PMID: 37732706 DOI: 10.1002/kjm2.12761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/20/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Clinical manifestations of phlebosclerotic colitis (PC) exhibit significant variability, necessitating diverse treatment strategies depending on disease severity. However, there is limited research exploring the relationship between imaging findings and disease severity. Hence, this retrospective study aimed to analyze the correlation between computed tomography (CT) findings, colonoscopic features, and disease severity. This study compared the abdominal CT characteristics, colonoscopy findings, and treatment modalities of 45 PC patients. CT images were assessed for the severity of mesenteric venous calcification, maximum colonic wall thickness, number of involved colonic segments, and presence of pericolic inflammation. Colonoscopic images were assessed for dark purple discoloration mucosa, erosive and ulcerative lesions, mucosal edema, luminal narrowing, and the number of involved colonic segments. In addition, patients were categorized into three groups: the observation (n = 15), medical treatment (n = 19), and operation (n = 11) groups. In CT images, a significant difference in pericolic inflammation (p = 0.039) was observed among groups. Further, significant differences in dark purple discoloration mucosa (p = 0.033), erosive or ulcerative lesions (p < 0.001), mucosal edema (p < 0.001), luminal narrowing (p = 0.012), and the number of involved colonic segments (p = 0.001) were observed in colonoscopy. Moreover, we found positive correlations between CT and colonoscopy features. In conclusion, CT manifestations and colonoscopy findings exhibited correlation with disease severity in PC. When limited to one diagnostic tool, observations from that tool can infer potential manifestations of the alternative tool.
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Affiliation(s)
- Pin-Yi Wang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Kung-Hsun Weng
- Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan
| | - Jyun-Yan Liou
- Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan
| | - Hsing-Tao Kuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Ming-Jen Sheu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
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Kim T, Lee J, Na JE, Park YE, Park J, Kim TO. Phlebosclerotic Colitis in a Healthy Young Female with Long-term Herbal Medicine Use. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2023; 82:30-34. [PMID: 37489080 DOI: 10.4166/kjg.2023.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/26/2023]
Abstract
Phlebosclerotic colitis is a rare form of intestinal ischemia. It is caused by calcified peripheral mesenteric veins and a thickened colonic wall. These characteristic findings can be identified on CT and colonoscopy. A 37-year-old female with a history of long-term herbal medicine use presented with acute lower abdominal pain and vomiting of sudden onset. Colonoscopic findings showed dark-blue discolored edematous mucosa and multiple ulcers from the ascending colon to the sigmoid colon. Abdominal CT findings showed diffuse thickening of the colonic wall and calcifications of the peripheral mesenteric veins from the ascending colon to the sigmoid colon. Based on these findings, the patient was diagnosed with phlebosclerotic colitis. We report this rare case of phlebosclerotic colitis in a healthy young female patient with a history of long-term herbal medicine use and include a review of the relevant literature.
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Affiliation(s)
- Taehong Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jin Lee
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ji Eun Na
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yong Eun Park
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jongha Park
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Tae Oh Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Chuah YY, Guo MMH, Lee YY. Not all right lower abdominal pain is appendicitis. Br J Hosp Med (Lond) 2023; 29:1. [PMID: 36989145 DOI: 10.12968/hmed.2022.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Affiliation(s)
- Yoen Young Chuah
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ping Tung Christian Hospital, Ping Tung City, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Mindy Ming Huey Guo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yeong Yeh Lee
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bahru, Malaysia
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Shan J, Chen F, Yu P. Intestinal obstruction due to idiopathic mesenteric phlebosclerosis colitis: A case report. Front Surg 2022; 9:969154. [PMID: 36061039 PMCID: PMC9428392 DOI: 10.3389/fsurg.2022.969154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Idiopathic mesenteric phlebosclerosis colitis (IMP) is a rare condition that impairs colonic venous blood return owing to mesenteric venous sclerosis and fibrosis. At present, many studies have suggested that long-term intake of Chinese herbal medicines is associated with its pathogenesis. IMP has no characteristic clinical manifestations, and most patients with IMP present with acute intestinal obstruction. As a rare disease, the etiology, pathogenesis, pathophysiology, and treatment of IMP are being explored and studied. Case Description A 60-year-old Chinese male patient with IMP was admitted to our hospital for acute intestinal obstruction, received subtotal colectomy and ileostomy after 10 days of ineffective conservative treatment, and was discharged after postoperative supportive treatment for 1 month. Conclusion There are many causes of intestinal obstruction, and we report a relatively rare one. After failure of conservative treatment, it is necessary to surgically resect part of the diseased bowel.
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Affiliation(s)
- Jiaqi Shan
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Fangci Chen
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Panpan Yu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Gastrointestinal Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
- Correspondence: Panpan Yu
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Widespread mesenteric phlebosclerosis presenting as intestinal obstruction due to stenosis of the right-sided colon. Clin J Gastroenterol 2022; 15:717-721. [PMID: 35489002 DOI: 10.1007/s12328-022-01637-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 02/07/2023]
Abstract
Mesenteric phlebosclerosis is a rare form of intestinal ischemia characterized by thickening of the right-sided colon and calcification of the mesenteric vein. We describe the case of a 58-year-old woman admitted to our hospital because of abdominal pain and distension. An abdominal computed tomography study revealed remarkable dilatation and fluid collection of the small intestine compatible with intestinal obstruction, which was considered to be the result of stenosis of the ascending colon. The thickened wall of the cecum and ascending colon was associated with calcification of the colonic wall and mesenteric veins. Colonoscopy showed dark purple discoloration of the edematous mucosa from the splenic flexure through the hepatic flexure, at which point the colonoscope could not be advanced further because of stenosis of the ascending colon. Over 10 years previously, the patient had taken an herbal medicine containing gardenia fruit, which can cause mesenteric phlebosclerosis. An extensive colonic resection was performed after intestinal decompression. This case highlights extensive mesenteric phlebosclerosis causing intestinal obstruction from the cecum through the proximal portion of the sigmoid colon, which was treated with extensive colonic resection.
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Jin YR, Zhou H, Liu ZZ, Li XF, Liang J. Idiopathic mesenteric phlebosclerosis occurring after long-term medication with licorice: A case report. J Dig Dis 2022; 23:183-185. [PMID: 35156308 DOI: 10.1111/1751-2980.13087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/17/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Yi Rong Jin
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - He Zhou
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Zhen Zhen Liu
- Digestive Disease Department, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi Province, China
| | - Xiao Fei Li
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Jie Liang
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, Shaanxi Province, China
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Mohigefer J, Gómez-Millán P, Borrero JJ. Phlebosclerotic colitis in a non-Asian patient: a case report. J Med Case Rep 2021; 15:349. [PMID: 34274012 PMCID: PMC8286582 DOI: 10.1186/s13256-021-02930-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/25/2021] [Indexed: 12/22/2022] Open
Abstract
Background Phlebosclerotic colitis is a rare condition with a high mortality. It has been seen almost exclusively in Asian patients who are ≥ 60 years old, with a slight male predominance. Although it predominantly affects the right colon and seems to be related in some cases to using natural herbal medicines, neither its etiology nor its pathogenesis are known. Case presentation We present an extremely rare case of a 62-year-old Spanish white man patient of non-Asian ethnicity with no history of using natural medications, who was diagnosed with phlebosclerotic colitis of submucosal veins. Conclusion To date, this is the only case reported in Spain, and only the second reported for Europe, in the literature. Due to the nonspecific symptoms and insidious radiological findings of this disease (both in early and mild stages) as well as exclusive submucosal involvement presented here, it is necessary that the treating physician has a high level of suspicion for its diagnosis.
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Affiliation(s)
- J Mohigefer
- Pathology Unit, Hospital Universitario Virgen del Rocío, Seville, Spain.
| | - P Gómez-Millán
- Radiology Unit, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - J J Borrero
- Pathology Unit, Hospital Universitario Virgen del Rocío, Seville, Spain
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Wen Y, Chen YW, Meng AH, Zhao M, Fang SH, Ma YQ. Idiopathic mesenteric phlebosclerosis associated with long-term oral intake of geniposide. World J Gastroenterol 2021; 27:3097-3108. [PMID: 34168411 PMCID: PMC8192294 DOI: 10.3748/wjg.v27.i22.3097] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/30/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Idiopathic mesenteric phlebosclerosis (IMP) is a rare disease, and its etiology and risk factors remain uncertain.
AIM To investigate the possible influence of Chinese herbal liquid containing geniposide on IMP.
METHODS The detailed formula of herbal liquid prescriptions of all patients was studied, and the herbal ingredients were compared to identify the toxic agent as a possible etiological factor. Abdominal computed tomography (CT) and colonoscopy images were reviewed to determine the extent and severity of mesenteric phlebosclerosis and the presence of findings regarding colitis. The disease CT score was determined by the distribution of mesenteric vein calcification and colon wall thickening on CT images. The drinking index of medicinal liquor was calculated from the daily quantity and drinking years of Chinese medicinal liquor. Subsequently, Spearman’s correlation analysis was conducted to evaluate the correlation between the drinking index and the CT disease score.
RESULTS The mean age of the 8 enrolled patients was 75.7 years and male predominance was found (all 8 patients were men). The patients had histories of 5-40 years of oral Chinese herbal liquids containing geniposide and exhibited typical imaging characteristics (e.g., threadlike calcifications along the colonic and mesenteric vessels or associated with a thickened colonic wall in CT images). Calcifications were confined to the right-side mesenteric vein in 6 of the 8 patients (75%) and involved the left-side mesenteric vein of 2 cases (25%) and the calcifications extended to the mesorectum in 1 of them. The thickening of colon wall mainly occurred in the right colon and the transverse colon. The median disease CT score was 4.88 (n = 7) and the median drinking index was 5680 (n = 7). After Spearman’s correlation analysis, the median CT score of the disease showed a significant positive correlation with the median drinking index (r = 0.842, P < 0.05).
CONCLUSION Long-term oral intake of Chinese herbal liquid containing geniposide may play a role in the pathogenesis of IMP.
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Affiliation(s)
- Yang Wen
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - You-Wei Chen
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Ai-Hong Meng
- Department of Gastroenterology, Hangzhou Yuhang District Hospital of Traditional Chinese Medicine, Hangzhou 311100, Zhejiang Province, China
| | - Ming Zhao
- Department of Pathology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Song-Hua Fang
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Yan-Qing Ma
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
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Xu J, Jin M, Jiang Z, Ke Q, Li A, Zhu T, Lai M. Clinicopathological features of phlebosclerotic colitis. Pathol Res Pract 2020; 216:153193. [PMID: 32927306 DOI: 10.1016/j.prp.2020.153193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/23/2020] [Accepted: 08/23/2020] [Indexed: 12/24/2022]
Abstract
Phlebosclerotic colitis (PC) is a rare chronic ischemic colitis caused by venous reflux disorder. It is also called idiopathic mesenteric phlebosclerosis (IMP) due to unknown etiology. The disease is characterized by sclerosis of mesenteric vein and its branches as well as fibrosis, hyaline degeneration, calcification, thickening of colon wall. CT images show linear calcification in the colon mucosa as well as mesenteric vein and its branches. Endoscopy shows purple-blue mucosa with multiple erosion and ulceration. Microscopically, the colon mucosa shows fibrosis, hyaline degeneration and extensive thickening. The most characteristic lesion is fibrosis and calcification of the vessels especially the veins. Arteries in all layers of colon are also involved, but the injury is significant mild and less. We collected 10 confirmed patients from 2012 to 2019 in our hospital, studied their clinical histories in detail, summarized typical changes of CT images, endoscopic images and pathological sections, and made a detail follow-up. In addition to typical pathological changes, we also found that gardenia or its metabolites may be the pathogenic factor. Probablely, geniposide which is metabolized to genipin by β-glucosidase of colon flora in proximal colon, results in venous sclerosis. PC is occult onset and irreversible without special symptoms in the early stage, but it will also be stable after removing the pathogenic ingredient. Most of patients may be "cured" by appropriate conservative medication and stopping drinking. Contrary, inappropriate surgery may "trigger" the acute ischemia which results in obstruction rapidly. We hope our colleagues pay attention to the unique lesion and make early diagnosis and treatment.
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Affiliation(s)
- Jing Xu
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China
| | - Mei Jin
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China
| | - Zhinong Jiang
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China
| | - Qinbing Ke
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China
| | - Aiqing Li
- Departmentof Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China
| | - Tao Zhu
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China
| | - Maode Lai
- Department of Pathology, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, PR China.
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Liu YC, Lee WJ. An unusual cause of intestinal obstruction: phlebosclerotic colitis. Intern Emerg Med 2020; 15:335-336. [PMID: 31782055 DOI: 10.1007/s11739-019-02241-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/19/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Yu-Chang Liu
- Department of Emergency Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang Dist., Tainan City, 710, Taiwan
| | - Wei-Jing Lee
- Department of Emergency Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang Dist., Tainan City, 710, Taiwan.
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12
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Hu YB, Hu ML, Ding J, Wang QY, Yang XY. Mesenteric phlebosclerosis with amyloidosis in association with the long-term use of medicinal liquor: A case report. World J Clin Cases 2020; 8:798-805. [PMID: 32149063 PMCID: PMC7052551 DOI: 10.12998/wjcc.v8.i4.798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/07/2020] [Accepted: 01/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mesenteric phlebosclerosis (MP) is a rare disease of the colon. The clinical manifestations of this disease are nonspecific and it may easily be misdiagnosed. We report a case of MP with amyloidosis in the colonic vessel walls in a patient with hypertension who had been consuming Chinese medicinal liquor for 10 years. We also review the relevant literature and summarize the characteristics of MP in patients in mainland China.
CASE SUMMARY A 64-year-old man was referred to our department from his primary hospital because of abdominal pain, diarrhea, and fever for almost 10 d. Computed tomography showed colon wall thickening, with threadlike calcifications in the mesenteric vein in the transverse colon. Colonoscopy revealed purple-blue mucosa with multiple ulcers in the ascending and transverse colon. Biopsy showed thickening and calcification of the vein walls, perivascular and mucosal collagen degeneration, and amyloidosis. The patient had been consuming Chinese medicinal liquor, mainly that made from gardenia fruit, for 10 years. Based on these results, a diagnosis of MP with amyloidosis was made. After conservative treatment, the patient’s discomfort subsided and he was followed closely. The use of Chinese herbal medicine was suspected to play a role in the pathogenesis of MP.
CONCLUSION The clinical manifestations of MP are nonspecific. Recognition of its typical imaging findings, including multiple calcifications on computed tomography and purple-blue mucosal discoloration on colonoscopy, is vital.
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Affiliation(s)
- Yi-Bing Hu
- Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China
| | - Min-Li Hu
- Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China
| | - Jin Ding
- Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China
| | - Qun-Ying Wang
- Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China
| | - Xiao-Yun Yang
- Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China
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13
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Kao C, Lin P, Chang L, Hsu W, Tu C, Chiu H, Chang C. A rare cause of ischemic colitis: A case series of idiopathic mesenteric phlebosclerotic colitis from two medical centers in Taiwan. ADVANCES IN DIGESTIVE MEDICINE 2020. [DOI: 10.1002/aid2.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Chien‐Neng Kao
- Division of Gastroenterology and Hepatology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
| | - Pao‐Ying Lin
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Taipei Medical University Hospital Taipei Taiwan
| | - Li‐Chun Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
- Health Management Center National Taiwan University Hospital Taipei Taiwan
| | - Wen‐Feng Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
| | - Chia‐Hung Tu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
- Health Management Center National Taiwan University Hospital Taipei Taiwan
| | - Han‐Mo Chiu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
- Health Management Center National Taiwan University Hospital Taipei Taiwan
| | - Chun‐Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Taipei Medical University Hospital Taipei Taiwan
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Adverse Events Associated with Ethical Kampo Formulations: Analysis of the Domestic Adverse-Event Data Reports of the Ministry of Health, Labor, and Welfare in Japan. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:1643804. [PMID: 31118950 PMCID: PMC6500660 DOI: 10.1155/2019/1643804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/07/2019] [Indexed: 12/13/2022]
Abstract
Objectives Traditional Japanese Kampo medicines have been integrated into the Japanese national health-care system. In Japan, the Ministry of Health, Labor, and Welfare's website discloses adverse drug-event data that have been obtained from medical personnel reports investigated by the Pharmaceutical and Medical Devices Agency. Using these data, we investigated adverse events associated with ethical Kampo formulations. Methods Reports of adverse events associated with ethical Kampo formulations from the domestic adverse-event data were obtained from July 30, 2003, to March 31, 2018. Adverse events were then categorized, and the relationships between categories of adverse events and crude drugs were analyzed. Results There were 4,232 reported adverse events associated with ethical Kampo formulations. The numbers of events by category were as follows: events related to liver injury, 1,193; lung injury, 1,177; pseudoaldosteronism, 889; mesenteric phlebosclerosis, 223; drug eruption, 185; and others, 565. Among events related to both liver injury and lung injury, approximately 70% were suspected to be induced by Kampo formulations containing Scutellariae Radix. The pseudoaldosteronism-related events, which are induced by Glycyrrhizae Radix, included several events related to muscle injury, heart failure, and arrhythmia. Events related to mesenteric phlebosclerosis, believed to be induced by long-term use of Kampo formulas containing Gardeniae Fructus, increased remarkably during the study period. Among the events related to drug eruption, approximately 35% were suspected to be induced by Kampo formulations containing Ephedrae Herba. Conclusion Kampo medicines may cause various adverse events. The present results provide valuable information regarding adverse events associated with Kampo medicines from the viewpoint of patient safety.
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Chen W, Zhu H, Chen H, Shan G, Xu G, Chen L, Dong F. Phlebosclerotic colitis: Our clinical experience of 25 patients in China. Medicine (Baltimore) 2018; 97:e12824. [PMID: 30412073 PMCID: PMC6221691 DOI: 10.1097/md.0000000000012824] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The aim of the current study was to enhance the awareness of phlebosclerotic colitis (PC) through our clinical experience.A retrospective review of 25 patients who were diagnosed as PC in our 2 affiliated hospitals from January 2013 to October 2017 was conducted.The patients were found at a mean age of 63.5 years, range 47 to 87years. The majority of patients were male (23 cases). Only 4 patients (16%, 4/25) had the history about long-term use of Chinese herbs and medical liquor. The most common symptoms were abdominal pain (40%) and intestinal obstruction (16%), followed by diarrhea (12%), and gastrointestinal bleeding (12%), etc. Three cases (12%) had no symptoms. The varying degrees of calcifications along the colon and mesenteric venous were found in all of their computed tomography (CT) images. The lesions mainly located in transverse and ascending colon (60%, 15/25). The terminal ileum, the whole colon and rectum involvement were also been found. Fourteen patients had the examination of colonoscopy which all presented characteristic dark purple-colored endoscopic findings. Conservative treatment with close follow-up was preferred in our group. Three cases had the surgery of colectomy due to the repeatedly intestinal obstruction, perforation.The PC was a very rare but characteristic entity with unclear etiopathogenesis. Examination of abdomen CT and colonoscopy could help you to make clinical diagnosis.
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Affiliation(s)
- Wenguo Chen
- Department of Gastroenterology, The First Affiliated Hospital
| | - Huatuo Zhu
- Department of Gastroenterology, The First Affiliated Hospital
| | - Hongtan Chen
- Department of Gastroenterology, The First Affiliated Hospital
| | - Guodong Shan
- Department of Gastroenterology, The First Affiliated Hospital
| | - Guoqiang Xu
- Department of Gastroenterology, The First Affiliated Hospital
| | - Lihua Chen
- Department of Gastroenterology, The First Affiliated Hospital
| | - Fei Dong
- Department of Radiology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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16
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Sun CS, Chen JJ, Lee PL, Chen MJ, Win KT. Idiopathic mesenteric phlebosclerosis caused by traditional medicine in a married couple and review of literature. ADVANCES IN DIGESTIVE MEDICINE 2018. [DOI: 10.1002/aid2.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Chi-Su Sun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine; Chi-Mei Medical Center; Tainan Taiwan
| | - Jyh-Jou Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine; Chi-Mei Medical Center; Tainan Taiwan
| | - Pei-Lun Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine; Chi-Mei Medical Center; Tainan Taiwan
| | - Ming-Jenn Chen
- Department of General Surgery; Chi-Mei Medical Center; Tainan Taiwan
| | - Khin-Than Win
- Department of Pathology; Chi-Mei Medical Center; Tainan Taiwan
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17
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Klein S, Buchner D, Chang DH, Büttner R, Drebber U, Fries JWU. Exclusive Phlebosclerosis of Submucosal Veins Leading to Ischemic Necrosis and Perforation of the Large Bowel: First European Case. Case Rep Gastroenterol 2018; 12:137-142. [PMID: 29805356 PMCID: PMC5968294 DOI: 10.1159/000488195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/01/2018] [Indexed: 12/12/2022] Open
Abstract
Phlebosclerotic colitis (PC) is a rare, potentially life-threatening disease of unclear pathogenesis almost exclusively reported in Asian patients of both genders. A fibrous degeneration of venous walls leads to threadlike calcifications along mesenteric vessels and colonic wall thickening, detectable by CT. This causes disturbed blood drainage and hemorrhagic infarction of the right-sided colonic wall. This is a report of PC in a Caucasian woman in Europe without Asian background and no history of herbal medications, a suspected cause in Asian patients. CT revealed no calcification of the mesenteric vein or its tributaries. Instead, submucosal veins of the left-sided colonic wall were calcified, leading to subsequent transmural necrosis. Clinically, the patient developed a paralytic ileus and sigmoidal perforation during a 2-week hospitalization due to a bleeding cerebral vascular aneurysm. This case of a European woman with PC is unique in its course as well as its radiologic, clinical, and pathologic presentation.
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Affiliation(s)
- Sebastian Klein
- Institute for Pathology, University Hospital Cologne, Cologne, Germany
| | - Denise Buchner
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - De-Hua Chang
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Reinhard Büttner
- Institute for Pathology, University Hospital Cologne, Cologne, Germany
| | - Uta Drebber
- Institute for Pathology, University Hospital Cologne, Cologne, Germany
| | - Jochen W U Fries
- Institute for Pathology, University Hospital Cologne, Cologne, Germany
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18
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Chan STK, Foo CC, Law WL. Rare cause of colitis with calcified mesenteric veins. ANZ J Surg 2017; 89:613-614. [PMID: 28982224 DOI: 10.1111/ans.14212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/26/2017] [Accepted: 07/30/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Steward Tsz Kiu Chan
- Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, China
| | - Chi Chung Foo
- Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, China
| | - Wai Lun Law
- Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, China
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19
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Ku MC, Kok VC, Lee CK. An Unusual Cause of Ischemic Change of Long Segment of Colon. Gastroenterology 2017; 152:e12-e13. [PMID: 28384451 DOI: 10.1053/j.gastro.2016.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 09/27/2016] [Accepted: 09/30/2016] [Indexed: 02/07/2023]
Affiliation(s)
- Ming-Chang Ku
- Department of Radiology, Kuang Tien General Hospital, Taichung, Taiwan; Department of Nursing, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Victor C Kok
- Division of Medical Oncology, Department of Internal Medicine, Kuang Tien General Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chien-Kuan Lee
- Department of Pathology, Kuang Tien General Hospital, Taichung, Taiwan
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20
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Shimizu S, Kobayashi T, Tomioka H, Ohtsu K, Matsui T, Hibi T. Involvement of herbal medicine as a cause of mesenteric phlebosclerosis: results from a large-scale nationwide survey. J Gastroenterol 2017; 52:308-314. [PMID: 27220772 DOI: 10.1007/s00535-016-1218-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/18/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Mesenteric phlebosclerosis (MP) is a rare disease characterized by venous calcification extending from the colonic wall to the mesentery, with chronic ischemic changes from venous return impairment in the intestine. It is an idiopathic disease, but increasing attention has been paid to the potential involvement of herbal medicine, or Kampo, in its etiology. Until now, there were scattered case reports, but no large-scale studies have been conducted to unravel the clinical characteristics and etiology of the disease. METHODS A nationwide survey was conducted using questionnaires to assess possible etiology (particularly the involvement of herbal medicine), clinical manifestations, disease course, and treatment of MP. RESULTS Data from 222 patients were collected. Among the 169 patients (76.1 %), whose history of herbal medicine was obtained, 147 (87.0 %) used herbal medicines. The use of herbal medicines containing sanshishi (gardenia fruit, Gardenia jasminoides Ellis) was reported in 119 out of 147 patients (81.0 %). Therefore, the use of herbal medicine containing sanshishi was confirmed in 70.4 % of 169 patients whose history of herbal medicine was obtained. The duration of sanshishi use ranged from 3 to 51 years (mean 13.6 years). Patients who discontinued sanshishi showed a better outcome compared with those who continued it. CONCLUSIONS The use of herbal medicine containing sanshishi is associated with the etiology of MP. Although it may not be the causative factor, it is necessary for gastroenterologists to be aware of the potential risk of herbal medicine containing sanshishi for the development of MP.
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Affiliation(s)
- Seiji Shimizu
- Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company, 5-9-1 Shirokane, Minato, Tokyo, 108-8642, Japan
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Hideo Tomioka
- Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company, 5-9-1 Shirokane, Minato, Tokyo, 108-8642, Japan
| | - Kensei Ohtsu
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Toshiyuki Matsui
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
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21
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Yang KH, Kwon TH, Park KS, Kim ES, Cho KB, Baek SK, Hwang I. [Idiopathic Myointimal Hyperplasia of Mesenteric Veins]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 67:54-7. [PMID: 27213200 DOI: 10.4166/kjg.2016.67.1.54] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Lee SH, Kim JW, Park SJ, Heo JY, Paik WH, Bae WK, Kim NH, Kim KA, Lee JS. Obstructive ileus caused by phlebosclerotic colitis. Intest Res 2016; 14:369-374. [PMID: 27799889 PMCID: PMC5083267 DOI: 10.5217/ir.2016.14.4.369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 06/23/2015] [Accepted: 07/01/2015] [Indexed: 12/24/2022] Open
Abstract
A 57-year-old man with chronic kidney disease and a history of using numerous herbal medications visited Inje University Ilsan Paik Hospital for abdominal pain and vomiting. An abdominal radiograph showed diffuse small bowel distension containing multiple air-fluid levels and extensive calcifications along the colon. Computed tomography showed colon wall thickening with diffuse calcification along the colonic mesenteric vein and colonic wall. Colonoscopy, performed without bowel preparation, showed bluish edematous mucosa from the transverse to the distal sigmoid colon, with multiple scar changes. At the mid transverse colon, a stricture was noted and the scope could not pass through. A biopsy of the stricture site revealed nonspecific changes. The patient was diagnosed with phlebosclerotic colitis. After the colonoscopy, the obstructive ileus spontaneously resolved, and the patient was discharged without an operation. Currently, after 2 months of follow-up, the patient has remained asymptomatic. Herein, we report the rare case of an obstructive ileus caused by phlebosclerotic colitis with a colon stricture.
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Affiliation(s)
- Seung Hyun Lee
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jong Wook Kim
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Se Jin Park
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Ju Yeol Heo
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Woo Hyun Paik
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Won Ki Bae
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Nam-Hoon Kim
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Kyung-Ah Kim
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - June Sung Lee
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
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Lin WC, Chen JH, Westphalen AC, Liao CH, Chen CH, Chen CM, Lin CH. The role of CT in predicting the need for surgery in patients diagnosed with mesenteric phlebosclerosis. Medicine (Baltimore) 2016; 95:e5139. [PMID: 27741142 PMCID: PMC5072969 DOI: 10.1097/md.0000000000005139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To determine if imaging findings on computed tomography (CT) can predict the need of surgery in patients with idiopathic mesenteric phlebosclerosis (IMP).This retrospective study included 28 patients with IMP. Abdominal CT images were reviewed to determine the extent and severity of mesenteric calcifications and the presence of findings related to colitides. We compared the number of colonic segments with mesenteric venous calcification, a total calcification score, and the rate of colonic wall thickening, pericolic fat stranding, and bowel loop dilatation between patients undergoing surgery (surgery group) and patients without surgery (nonsurgery group). Comparisons were made using the Mann-Whitney U test and Fisher exact test. Receiver operating characteristic analysis was also performed. Inter-reader agreement for the calcification scores was analyzed using kappa statistics.The number of colonic segments with mesenteric venous calcification and the total calcification scores were both significantly higher in the surgery group than the nonsurgery group (4.33 vs 2.96, P = 0.003; and 15.00 vs 8.96, P <0.001). The areas under the receiver operating characteristics to identify patients who need surgery were 0.96 and 0.92, respectively. The prevalence of bowel loop dilatation in the surgery group was also significantly higher than that in the nonsurgery group (16% vs 100%, P = 0.011).Evaluation of the severity and extent of IMP based on the total mesenteric venous calcification score, number of involved colonic segments, and the presence bowel loop dilatation on CT may be useful to indicate the outcomes of conservative treatment and need for surgery.
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Affiliation(s)
- Wei-Ching Lin
- Department of Radiology, China Medical University Hospital
- School of Medicine
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung
| | - Jeon-Hor Chen
- E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
- Center for Functional Onco-Imaging, School of Medicine, University of California, Irvine
| | - Antonio Carlos Westphalen
- Departments of Radiology and Biomedical Imaging, and Urology, University of California, San Francisco, CA
| | - Chun-Han Liao
- Department of Radiology, China Medical University Hospital
| | | | - Chun-Ming Chen
- Department of Radiology, China Medical University Hospital
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung
| | - Chien-Heng Lin
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung
- Division of Pediatric Pulmonology, China Medical University Children's Hospital
- Asia University, Taichung, Taiwan
- Correspondence: Chien-Heng Lin, Division of Pediatric Pulmonology, China Medical University Children's Hospital, 2 Yuh-Der Road, Taichung, 40447, Taiwan (e-mail: )
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Nagata Y, Watanabe T, Nagasaka K, Yamada M, Murai M, Takeuchi S, Murase M, Yazaki T, Murase T, Komatsu K, Kaizuka M, Sano M, Asano K, Ando C, Taniuchi N. Total dosage of gardenia fruit used by patients with mesenteric phlebosclerosis. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:207. [PMID: 27402114 PMCID: PMC4940942 DOI: 10.1186/s12906-016-1182-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 06/29/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mesenteric phlebosclerosis (MP) is a disease characterized by fibrotic change or calcification of the mesenteric vein. Recently, there has been an increase in case reports of MP related to herbal medicine usage. Long-term intake of gardenia fruit (GF) is suspected as a possible cause. However, many GF users do not develop this disease and the association between GF and MP remains unclear. In this study, we investigated for the first time the dosage of GF used by patients with and without MP. METHODS We used a medical chart review study design to assess the association between GF and MP. We reviewed patients with a history of intake of herbal medicines containing GF. Among these patients, we selected patients who were examined by colonoscopy and abdominal plain computed tomography (CT). We investigated the findings of colonoscopy, CT scan and histological examination. We assessed the total dosages of GF alongside the duration of ambulatory visit, the administration period of herbal medicine containing GF and pre-existing disease in order to compare MP cases and non-MP patients. RESULTS Ten MP cases and 42 non-MP patients were analyzed. We summarized clinical findings of MP cases. All MP cases used more GF than non-MP patients and were administered more than approximately 5,000 grams of GF in cumulative dosage. CONCLUSIONS This study indicated that excessive intake of GF contributes to and/or accelerates the development of MP suggesting that long-term usage of GF in excessive amounts increases the risk of MP.
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Affiliation(s)
- Yutaka Nagata
- Department of Oriental Traditional Medical Center, Suwa Central Hospital, 4300 Tamagawa, Chino, Nagano, 391-8503, Japan.
- River Side Clinic, Chino, Nagano, Japan.
| | - Tetsuo Watanabe
- Department of Japanese Oriental Medicine and Rheumatology, Toyama Prefectural Central Hospital, Toyama, Toyama, Japan
| | - Kazuhiko Nagasaka
- Department of Oriental Traditional Medical Center, Suwa Central Hospital, 4300 Tamagawa, Chino, Nagano, 391-8503, Japan
- River Side Clinic, Chino, Nagano, Japan
| | - Masaaki Yamada
- Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan
| | - Masafumi Murai
- Hokudaimae Clinic, Hokkaido Kampo Medical Center, Sapporo, Hokkaido, Japan
- Shinsapporo Keiaikai Hospital, Sapporo, Hokkaido, Japan
| | - Sunao Takeuchi
- Department of Internal medicine, Suwa Central Hospital, Chino, Nagano, Japan
| | - Mai Murase
- Department of Internal medicine, Suwa Central Hospital, Chino, Nagano, Japan
| | - Toshinori Yazaki
- Department of Internal medicine, Suwa Central Hospital, Chino, Nagano, Japan
| | - Takayuki Murase
- Department of Internal medicine, Suwa Central Hospital, Chino, Nagano, Japan
| | - Kenichi Komatsu
- Department of Surgery, Suwa Central Hospital, Chino, Nagano, Japan
| | - Machiko Kaizuka
- Department of Surgery, Suwa Central Hospital, Chino, Nagano, Japan
| | - Mika Sano
- Department of Radiology, Suwa Central Hospital, Chino, Nagano, Japan
| | - Koji Asano
- Department of Pathology, Suwa Central Hospital, Chino, Nagano, Japan
| | | | - Norihide Taniuchi
- Department of Internal medicine, Suwa Central Hospital, Chino, Nagano, Japan
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25
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Hoshino N, Hasegawa S, Hida K, Kawada K, Sakai Y. Right hemicolectomy for mesenteric phlebosclerosis potentially caused by long-term use of herbal medicine: A case report and literature review. Int J Surg Case Rep 2016; 24:191-4. [PMID: 27266839 PMCID: PMC4906139 DOI: 10.1016/j.ijscr.2016.05.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/23/2016] [Accepted: 05/27/2016] [Indexed: 02/08/2023] Open
Abstract
The extent of colon affected by MP varied a good deal between the cases. Computed tomography was useful to determine the extent of affected colon. MP caused by herbal medicine was often localized in the right colon. Limited colonic resection is usually indicated.
Introduction Mesenteric phlebosclerosis is a rare ischemic disease affecting the colon. Systemic disease and herbal medicine have been pointed out as possible causes, and the disease is characterized by calcifications involved the mesocolic veins. Patients who do not respond to conservative therapy require surgical treatment. In surgical intervention, an adequate extent of colonic resection is important. Presentation of case We present a case of an 87-year-old woman with mesenteric phlebosclerosis who had consumed herbal medicine for 40 years. She suffered from ileus caused by mesenteric phlebosclerosis, and the symptoms did not improve with conservative therapy. Right hemicolectomy was performed since the disease was localized in the right colon. Long-term use of herbal medicine was considered the potential cause of mesenteric phlebosclerosis. The postoperative course was mostly uneventful. The patient stopped using herbal medicine and had no signs of recurrence 2 years after surgery. Discussion and conclusion The greatest concern in surgery for mesenteric phleboscrerosis is to detect the affected area, which should be removed. Characteristic findings in computed tomography and intraoperative findings can help to determine the optimal extent of colonic resection. Mesenteric phlebosclerosis caused by herbal medicines occurs as localized disease in the right colon compared with mesenteric phlebosclerosis caused by other pathogenesis. Limited colonic resection is usually indicated for mesenteric phlebosclerosis caused by herbal medicine.
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Affiliation(s)
- Nobuaki Hoshino
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Suguru Hasegawa
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Koya Hida
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kenji Kawada
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yoshiharu Sakai
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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26
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Nagata Y, Watanabe T, Nagasaka K, Yamada M, Saito M, Yazaki T, Komatsu K, Sano M, Asano K, Ando C, Taniuchi N. Clinical Search for Undiagnosed Mesenteric Phlebosclerosis at Outpatient Departments Specializing in Herbal (Kampo) Medicine. Intern Med 2016; 55:573-81. [PMID: 26984071 DOI: 10.2169/internalmedicine.55.5642] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Mesenteric phlebosclerosis (MP) is a disease characterized by calcification of the mesenteric vein, which causes chronic mesenteric ischemia. Recently, the long-term intake of gardenia fruit ('Sanshishi' in Japanese) has been attracting attention as a possible cause. Usually, only advanced, severe MP cases get reported. However, we suspected that some latent cases of this disease may exist. We performed this study in order to determine the prediagnostic cases at our outpatient departments of herbal (Kampo) medicine, with particular attention paid to the initial changes, such as any slight color change of the colon, as shown in colonoscopy. METHODS We recommend colonoscopy and computed tomography (CT) scans for patients with a long-term history of taking herbal medicines containing gardenia fruit. Clinical examinations were performed upon receiving patients' consent from December 2013 to November 2014. RESULTS Of the 103 patients who took gardenia fruit long-term, 29 agreed to be checked for MP. 14 patients underwent colonoscopy. Four patients were confirmed to have MP due to the presence of fibrotic deposition of the colonic membrane on histological inspection. Twenty-one patients underwent abdominal CT screening. Characteristic calcification of the mesenteric vein was observed on CT scans in 2 patients. All 4 MP patients took Kampo formulas containing gardenia fruit for more than 6.8 years. The other patients did not develop MP, despite long-term gardenia fruit intake. CONCLUSION We detected the latent and undiagnosed MP cases. All diagnoses were made while paying careful attention to any slight changes in colonoscopy and CT scans.
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Affiliation(s)
- Yutaka Nagata
- Department of Oriental Traditional Medical Center, Suwa Central Hospital, Japan
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27
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Chang YT, Hsu CW. Conservative treatment of idiopathic mesenteric phlebosclerosis. FORMOSAN JOURNAL OF SURGERY 2015. [DOI: 10.1016/j.fjs.2015.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lee SM, Seo JW. Phlebosclerotic colitis: case report and literature review focused on the radiologic findings in relation to the intake period of toxic material. Jpn J Radiol 2015; 33:663-7. [PMID: 26242772 DOI: 10.1007/s11604-015-0467-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/22/2015] [Indexed: 01/13/2023]
Abstract
Phlebosclerotic colitis (PC) is a rare disease entity of intestinal ischemia characterized by calcification at the right hemicolon and is predominant in Asian populations. We present a 57-year-old Korean patient who was an Oriental medicine practitioner himself and had been taking herbal medicine for decades. We reviewed previous literature on similar cases and analyzed radiologic features of PC in relation to the intake period of toxic material and extent of disease.
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Affiliation(s)
- So Min Lee
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang-Si, Gyeonggi-Do, 411-706, Republic of Korea.
| | - Jung Wook Seo
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang-Si, Gyeonggi-Do, 411-706, Republic of Korea.
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Yen TS, Liu CA, Chiu NC, Chiou YY, Chou YH, Chang CY. Relationship between severity of venous calcifications and symptoms of phlebosclerotic colitis. World J Gastroenterol 2015; 21:8148-8155. [PMID: 26185388 PMCID: PMC4499359 DOI: 10.3748/wjg.v21.i26.8148] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/06/2015] [Accepted: 04/09/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the correlation between the severity of venous calcifications and the clinical symptoms of phlebosclerotic colitis.
METHODS: This was a retrospective study. The data, including the numbers of episodes of active disease, were collected from the medical records at Taipei Veterans General Hospital and Wei Gong Memorial Hospital in Taiwan between January 2005 and December 2014. All computed tomography images with or without contrast enhancement were obtained using a multiple detector computed tomography scanner. The scanning range reached from the dome of the diaphragm to the pelvis. The severity of calcification at the tributaries of the portal vein was measured using a four-grade scoring system of the calcification of phlebosclerotic colitis. The episodes of active disease were defined as symptoms of fever, abdominal pain, severe constipation, bowel obstruction, vomiting or diarrhea based on a review of the medical records. Spearman’s correlation analysis was used to examine the correlation between the numbers of episodes of active disease and the severity of the calcification of the mesenteric veins.
RESULTS: More than 3000 cases were reviewed from 2005 to 2014, and a total of 12 patients from Taipei Veterans General Hospital and Wei Gong Memorial Hospital were enrolled according to our inclusion criteria. Among these 12 patients, the mean age of the six males and the six females was 61.8 ± 11.5 years. All patients exhibited typical imaging characteristics, consisting of threadlike calcifications and colonic wall thickening in the standard radiographs and calcifications along the colonic and mesenteric vessels or associated with colonic wall thickening and adjacent fat stranding in the computed tomography images. The median score of the severity of the venous calcifications was 18 ± 13, and the median number of active disease episodes was 1 ± 1.75. Spearman’s correlation analysis revealed that the number of episodes of active phlebosclerotic colitis disease significantly positively correlated with the severity of the calcification of the mesenteric veins (r = 0.619, P < 0.05).
CONCLUSION: The extent of mesenteric venous calcification is strongly associated with the number of episodes of active disease among patients with phlebosclerotic colitis.
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Abbott S, Hewett P, Cooper J, Ruszkiewicz A. Idiopathic myointimal hyperplasia of the mesenteric veins: a rare differential to be considered in idiopathic colitis. ANZ J Surg 2015; 88:242-243. [PMID: 26139020 DOI: 10.1111/ans.13210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah Abbott
- D, epartment of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Peter Hewett
- D, epartment of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.,Department of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - John Cooper
- SA Pathology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Andrew Ruszkiewicz
- SA Pathology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Choi JM, Lee KN, Kim HS, Lee SK, Lee JG, Lee SW, Lee OY, Choi HS. Idiopathic phlebosclerotic colitis: a rare entity of chronic ischemic colitis. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 63:183-6. [PMID: 24651592 DOI: 10.4166/kjg.2014.63.3.183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Colonic wall thickening is frequently encountered in various conditions, from acute or chronic inflammatory disease to colorectal carcinoma. Colonic wall thickening may be accompanied by calcifications in mucinous adenocarcinoma of the colon, leiomyosarco-ma of the colon, schistosomiasis japonica, and phlebosclerotic colitis. Phlebosclerotic colitis is a rare entity of chronic ischemic colitis associated with sclerosis and fibrosis of mesenteric veins. Although its development is usually insidious, and, thus its diagnosis can be delayed, characteristic findings in phlebosclerotic colitis are calcifications of mesenteric veins as well as colonic wall thickening with calcifications. We report on a 71-year-old woman who presented with chronic diarrhea and intermittent hematochezia, who was first misdiagnosed as mucinous adenocarcinoma of the colon, but finally diagnosed as a rare entity of chronic ischemic colitis, phlebosclerotic colitis. Differential points of phlebosclerotic colitis from other diseases, including leiomyosarcoma and schistosomiasis japonica, are also described.
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Affiliation(s)
- Jong Min Choi
- Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea
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Chang YY, Lin HH, Lin CC. Phlebosclerotic colitis presenting as intestinal obstruction. Clin Gastroenterol Hepatol 2014; 12:e81-2. [PMID: 24561098 DOI: 10.1016/j.cgh.2014.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 02/11/2014] [Accepted: 02/14/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Yu-Yao Chang
- Department of Surgery, Changhua Christian Medical Foundation Erlin Christian Hospital, Changhua, Taiwan; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hung-Hsin Lin
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Chi Lin
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
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Fang YL, Hsu HC, Chou YH, Wu CC, Chou YY. Phlebosclerotic colitis: A case report and review of the literature. Exp Ther Med 2014; 7:583-586. [PMID: 24520249 PMCID: PMC3919902 DOI: 10.3892/etm.2014.1492] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 12/18/2013] [Indexed: 12/24/2022] Open
Abstract
Phlebosclerotic colitis (PC) is a rare but potentially life-threatening disease. The initial presentation may include non-specific symptoms, such as vomiting, constipation and abdominal pain; however, intestinal stenosis, gangrene and perforation may occur without appropriate management. The present report describes the case of a 56-year-old male with abdominal pain and constipation. Imaging studies revealed thread-like calcifications involving almost the entire colon, which had markedly progressed over a three-year period, and changes consistent with colonic ischemia. Angiography revealed decreased blood flow in the mesenteric veins. The patient underwent emergent subtotal colectomy, and pathological examination revealed gangrene of the colon and calcifications of the mesenteric veins. The patient’s postoperative course was uneventful. In conclusion, PC is a potentially life-threatening condition that may be diagnosed by the presence of serpentine calcifications on imaging studies. Management depends on the severity of the disease, ranging from close follow-up to prompt surgical intervention.
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Affiliation(s)
- Yue-Lin Fang
- Division of General Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, R.O.C
| | - Ho-Chi Hsu
- Division of General Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, R.O.C
| | - Yenn-Hwei Chou
- Division of General Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, R.O.C
| | - Chin-Chu Wu
- Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, R.O.C
| | - Yuh-Yu Chou
- Department of Pathology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, R.O.C
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Huang YW, Siao FY, Yen HH. Unusual cause of abdominal pain. Gastroenterology 2013; 144:886, 1159-60. [PMID: 23523849 DOI: 10.1053/j.gastro.2012.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 12/11/2012] [Indexed: 12/02/2022]
Affiliation(s)
- Yen-Wei Huang
- Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
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Hiramatsu K, Sakata H, Horita Y, Orita N, Kida A, Mizukami A, Miyazawa M, Hirai S, Shimatani A, Matsuda K, Matsuda M, Ogino H, Fujinaga H, Terada I, Shimizu K, Uchiyama A, Ishizawa S, Abo H, Demachi H, Noda Y. Mesenteric phlebosclerosis associated with long-term oral intake of geniposide, an ingredient of herbal medicine. Aliment Pharmacol Ther 2012; 36:575-86. [PMID: 22817400 DOI: 10.1111/j.1365-2036.2012.05221.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Revised: 06/27/2012] [Accepted: 06/29/2012] [Indexed: 01/13/2023]
Abstract
BACKGROUND Idiopathic mesenteric phlebosclerosis (IMP) is a rare disease, characterised by thickening of the wall of the right hemicolon with calcification of mesenteric veins. However, the aetiology remains unknown. AIM To investigate the possible association of herbal medicines with IMP. METHOD The clinical data of four of our own patients were collected. Furthermore, we searched for previous reports about similar patients with detailed descriptions of herbal prescriptions that they had taken. We compared herbal ingredients to identify the toxic agent as a possible aetiological factor. RESULTS Clinical data on a total of 25 patients were summarised. Mean age was 61.8 years and there was female predominance (6 men and 19 women). The used Kampo prescription, the number of cases, and the mean duration of use were as follows: kamisyoyosan in 12 cases for 12.8 years, inshin-iseihaito in 5 cases for 13.4 years, orengedokuto in 4 cases for 14.3 years, inchinkoto in 1 case for 20 years, kamikihitou in 1 case for 19 years, seijobofuto in 1 case for 10 years and gorinsan in 1 case for an unknown duration. Only one ingredient, sansisi, was common to the herbal medicines of all 25 patients. This crude drug called geniposide in English is a major constituent of the Gardenia fruits. CONCLUSION The long-term use of geniposide in herbal medicines appears to be associated with mesenteric phlebosclerosis.
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Affiliation(s)
- K Hiramatsu
- Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.
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Lin PY, Chai CY, Chang CC. Recurrent abdominal pain in a 55-year-old woman. Diagnosis: Idiopathic mesenteric phlebosclerosis. Gastroenterology 2011; 141:36-404. [PMID: 21620850 DOI: 10.1053/j.gastro.2010.08.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 08/23/2010] [Indexed: 12/13/2022]
Affiliation(s)
- Pao-Ying Lin
- Department of Internal Medicine, Taipei Medical University Hospital, Taiwan, ROC
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Kato T, Miyazaki K, Nakamura T, Tan KY, Chiba T, Konishi F. Perforated phlebosclerotic colitis--description of a case and review of this condition. Colorectal Dis 2010; 12:149-51. [PMID: 19175648 DOI: 10.1111/j.1463-1318.2008.01726.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- T Kato
- Department of Surgery, Jichi Medical School Saitama Medical Centre, Saitama, Japan
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Yoshii S, Tsukagoshi H, Kusumi T, Suzuki Y. Idiopathic Mesenteric Phrebosclerosis: Long-term Use of the Chinese Herbs -Report of Four Cases. ACTA ACUST UNITED AC 2010. [DOI: 10.3862/jcoloproctology.63.389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Miyazaki M, Nakamura S, Matsumoto T. Idiopathic mesenteric phlebosclerosis occurring in a wife and her husband. Clin Gastroenterol Hepatol 2009; 7:e32-3. [PMID: 19514111 DOI: 10.1016/j.cgh.2009.01.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Masashi Miyazaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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YAMANAKA N, MATOBA N, YOKOHATA K, NOGUCHI H, KAMEOKA N. TWO CASES OF IDIOPATHIC MESENTERIC PHLEBOSCLEROSIS. ACTA ACUST UNITED AC 2009. [DOI: 10.3919/jjsa.70.3151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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