2020 Volume 45 Issue 3 Pages 238-243
We report a case of mesenteric phlebosclerosis (MP), which is a rare ischemic colon disease that was described recently. A 70-year-old woman was referred to our hospital with abdominal pain and fever. She had a past medical history of SLE and hypertension, and was receiving oral herbal medicines (kamishoyosan). Blood tests showed evidence of an inflammatory reaction. Abdominal computed tomography (CT) showed thickening of the colonic wall of the right-sided colon and a high-density lesion around the hepatic flexure of the colon, with linear calcification of the marginal vessels. She was diagnosed as having ischemic colitis and received conservative therapy; the herbal medicines were discontinued. Colonoscopy and X-ray fluoroscopy revealed stenosis at the hepatic flexure, therefore, we performed right hemicolectomy. Histopathological examination revealed denudation of the mucosa, submucosal fibrosis, and fibrous thickening of the venous walls with calcification, consistent with the diagnosis of MP. The postoperative course was uneventful, and the patient has shown no evidence of relapse after the surgery. Early diagnosis of MP may allow avoidance of surgery, although MP should be kept in mind as a cause of acute abdomen.
