Idiopathic mesenteric phlebosclerosis missed by a radiologist at initial diagnosis: A case report  

作　　者：Min Wang Yu-Xia Wan Jin-Wen Liao Fei Xiong 

机构地区：[1]Department of Gastroenterology,Changning County People’s Hospital,Yibin 644300,Sichuan Province,China [2]Department of Gastroenterology,Qianwei People’s Hospital,Leshan 614400,Sichuan Province,China [3]Department of Gastroenterology,The People’s Hospital of Jianyang City,Chengdu 641400,Sichuan Province,China [4]Department of Gastroenterology,Sichuan Provincial People’s Hospital,University of Electronic Science and Technology of China,Chengdu 610000,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2024年第10期1810-1816,共7页世界临床病例杂志

摘　　要：BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare type of ischemic colitis characterized by thickening of the wall of the right hemicolon and calcification,sclerosis,and fibrosis of mesenteric veins.The diagnosis of IMP is based on typical clinical features and imaging findings.We report a case of IMP that was initially missed by the radiologist.CASE SUMMARY A 77-year-old woman was admitted to the hospital due to chronic diarrhea for over 2 months.She had been consuming Chinese patent medicines(CPM)containing fructus gardeniae for more than 15 years.Colonoscopy revealed an edematous mucosa,bluish-purple discoloration,erosions,and ulcerations throughout the colorectal area.Abdominal computed tomography(CT)showed diffuse mural thickening of the entire colorectum,with tortuous thread-like calcifications in the right hemicolon,left hemicolon,and rectum.Most of the calcifications were located in the mesenteric vein.The diagnosis of IMP was established based on medical history,colonoscopy,CT findings,and histopathological examination.The patient was treated conservatively with papaverine and rifaximin,and CPM was stopped.Her diarrhea symptoms improved,indicating the effectiveness of the treatment.Over the next several years,she took opium alkaloids for an extended period and did not require hospitalization for the aforementioned gastrointestinal disorder.CONCLUSION IMP is a rare gastrointestinal disease affecting Asian populations,possibly related to long-term herbal medicine intake.Accurate imaging analysis is crucial for diagnosis,but insufficient understanding of the disease can lead to misdiagnosis or missed diagnosis.Treatment strategies should be personalized.

关 键 词：Idiopathic mesenteric phlebosclerosis Computed tomography COLONOSCOPY Chinese patent medicines Fructus gardeniae Case report 

分 类 号：R563.1[医药卫生—呼吸系统]