Abstract
A 77-year-old woman complaining of high fever and vomiting was admitted to the hospital with a suspicion of gastroenteritis. On the next morning, lower abdominal pain appeared which gradually intensified, and the patient went into shock in that evening. An abdominal x-ray film showed calcification along the wall of the right colon. An abdominal CT scan revealed thickening of the wall and calcification from the ascending to transverse colon. Ascites and free air were also identified. Accordingly emergency laparotomy was performed with a suspected diagnosis of general peritonitis due to intestinal perforation. During surgery purulent ascites was noticed and the intestinal wall from the cecum to the descending colon was deep purple in color and was felt hard. A perforated portion about 1cm in size was present at the ascending colon, and colon perforation due to ischemic enteritis was diagnosed. The portion from the terminal ileum to the descending colon where changed in color was resected, and ileostomy was established. Pathological studies revealed fibrous hypertrophy of the venous wall, calcification around the veins, and submucosal fibrosis, so that mesenteric phlebosclerosis was diagnosed.
