A CASE OF IDIOPATHIC MESENTERIC PHLEBOSCLEROSIS TREATED WITH MESALAZINE

Abstract

A 67-year-old female was admitted to our hospital because of right lower abdominal pain. Colonoscopy showed an edematous, dark blue mucosa with ulcers and erosions in the ascending to the transverse colon. An abdominal CT scan showed linear venous calcifications around the ascending colon. Histologic examination of the biopsy specimens showed enlarged microvessels and the proliferation of collagenous fibers in the submucosal layer. Based on these findings we diagnosed idiopathic mesenteric phlebosclerosis (IMP). Induction therapy was performed by fasting and total parenteral nutrition, and then the patient began to receive mesalazine as maintenance. Induction therapy was effective and she has maintained clinical remission. Follow-up colonoscopy after one year revealed that ulcers and erosions had dramatically decreased and there was improvement in the edematous change. There has not been any definite therapeutic strategy for the disease. Oral mesalazine might contribute to the maintainance of remission for patients with IMP.