Mesenteric phlebosclerosis improved by discotinuation of kamisyoyosan, presented with a positive fecal occult blood test

Abstract

A 69-year-old woman was referred to the hospital because of a positive fecal occult blood test. She had taken kamisyoyosan continuously for twenty-five years due to menopausal syndrome and anxiety disorder. Colonoscopic examinations showed dark purple mucosa with irregular vascular structure from the cecum to the descending colon and a deep ulcer in the ascending colon. Plain abdominal radiograph showed calcification along the ascending colon.Abdominal CT revealed thickening of the colonic wall and calcification of the mesenteric vein. Histopathological findings disclosed fibrous thickening of the veins in the submucosa and collagen fiber deposits in the lamina propria. A diagnosis of mesenteric phlebosclerosis was made, then kamisyoyosan was discontinued. Colonoscopy after about a half year showed healed ulcer in the ascending colon.
As mesenteric phlebosclerosis may be discovered incidentally, endoscopic and radiographic characteristic images of the disease need be kept in mind. In patients with a long-term history of taking Chinese herbal medicines containing gardenia fruit colonoscopy or abdominal CT is thought usually necessary.