| Theme |
Vascular Disorder of Gastro-intestinal Tract |
| Title |
Diagnosis and Managementof Idiopathic Mesenteric Phlebosclerosis |
| Author |
Seiji Shimizu |
Division of Gastroenterology, Osaka Railway Hospital |
| Author |
Kayoko Shimizu |
Division of Gastroenterology, Osaka Railway Hospital |
| Author |
Wataru Fukuda |
Division of Gastroenterology, Osaka Railway Hospital |
| Author |
Yoshitaka Morimoto |
Division of Gastroenterology, Osaka Railway Hospital |
| Author |
Yasuhide Mitsumoto |
Division of Gastroenterology, Osaka Railway Hospital |
| Author |
Takahiro Mori |
Division of Gastroenterology, Osaka Railway Hospital |
| [ Summary ] |
Idiopathic mesenteric phlebosclerosis is a disorder characterized by calcification of veins in the intestine and mesentery, associated with chronic ischemia due to disturbed venous return. Symptoms include abdominal pain, diarrhea, nausea and vomiting. However, asymptomatic cases are not rare. Recently, Chinese herbal medicine has been considered to be a possible etiological factor. Lesions most often involve the right side of the colon, primarily the cecum and ascending colon. Macroscopic features include swelling or disappearance of semilunar folds, thickening and rigidity of intestinal walls, and discoloration (dark red to bronze) of the mucosa. These changes can be evaluated with barium enema X-rays or colonoscopy. Histological findings are fibrous mural thickening with calcification of veins, submucosal fibrosis and collagen deposition around vessels in the mucosa. Calcification of veins can be evaluated with plain X-rays or computed tomography. Concerning treatment, conservative therapy or observation alone are generally selected. However, surgical operations may be performed for seriously symptomatic patients. |