| Theme |
Gastrointestinal Disease Due to Blood Flow Damage |
| Title |
Mesenteric Phlebosclerosis |
| Author |
Takashi Hisabe |
Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author |
Kensei Ohtsu |
Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author |
Fumihito Hirai |
IBD Center, Fukuoka University Chikushi Hospital |
| Author |
Kenshi Yao |
Department of Endoscopy, Fukuoka University Chikushi Hospital |
| Author |
Toshiharu Ueki |
Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author |
Akinori Iwashita |
Department of Pathology, Fukuoka University Chikushi Hospital |
| [ Summary ] |
Mesenteric phlebosclerosis is a rare condition characterized by venous calcification extending between the colonic wall and the mesentery, with chronic ischemic changes secondary to impaired venous return. Plain radiography and abdominal computed tomography demonstrate calcified mesenteric veins. Colonoscopic examination reveals abnormal coloration (dark purple or bronze)，reduced distensibility, and stenosis along the right hemicolon, particularly affecting the ascending colon. Barium enema examination shows disappearance of the semilunar folds, luminal irregularities, rigidity, narrowing, and thumbprinting in the right hemicolon. Biopsies obtained from the affected sites show marked fibrous thickening of the venous walls with perivascular collagen deposition in the mucosa, which confirms the diagnosis. The intake of herbal medicine containing sanshishi is considered a pathogenetic contributor. Most patients show improvement in symptoms after discontinuing intake of herbal medicine containing sanshishi. Surgery is required in those with unrelenting abdominal pain and bowel stenosis. |