Abstract
A 37-year-old man with a 10-year history of atopic dermatitis used 14 kinds of Chinese herbal medicine and complained of abdominal pain and vomiting. Abdominal CT led to the suspicion of paralytic ileus due to idiopathic mesenteric phlebosclerosis (IMP). He was placed under conservative medical treatment and his symptoms were relieved, but he was re-hospitalized five days after discharge for recurrence of the symptoms. Abdominal CT also showed a large number of linear and granular calcifications along the colic wall from the cecum to the splenic flexure and the mesenteric vein. Total colonoscopic examination demonstrated a brown change in color from the cecum to the descending colon, and scattered ulcerations mainly on the transverse colon. Histopathological inspection led to a diagnosis of IMP. A laparoscopy-assisted extended right hemi-colectomy was performed, and the splenic flexure with good color and without edema was decided as the resection line. The patient remained well without preoperative symptoms at 36 months after the operation. The facts of this case suggest that withdrawal of the Chinese herbal medicine and decision on the excision range from intraoperative view were effective for the prevention of recurrence of the IMP.
