Chronic Phlebosclerotic Ischemic Colitis

腸系膜靜脈硬化合併鈣化，是造成慢性缺血性大腸炎相當罕見的原因。我們報告一例因靜脈硬化合併鈣化所引起之慢性缺血性大腸炎。一位65歲女性，主訴右下腹疼痛，飯後腹漲，長達半年之久。特有的影像及檢查特徵如下：(1) 腹部放射線攝影－在升結腸及橫結腸可以看出血管性之鈣化，(2) 腹部電腦斷層－大腸壁增厚及鈣化，並有腸系膜靜脈鈣化，(3) 下消化道攝影－大腸腔室變窄，腸壁變硬及指壓紋之腸壁外觀，(4) 上腸系膜動脈血管攝影－大腸之小動脈及周緣動脈狹窄或阻塞，靜脈回流受阻，(5) 大腸鏡－腸黏膜水腫，黏膜下腔靜脈擴張。

關鍵字

缺血性大腸炎；大腸電腦斷層；腸系膜血管；靜脈狹窄或堵塞

並列摘要

Phlebosclerosis of the mesenteric vein is a rare cause of ischemic colitis. The clinicopathologic findings of chronic phlebosclerotic ischemic colitis are different from conventional ischemic colitis. We report a case showing the following features: (1) plain abdominal radiography-vascular calcifications at the ascending colon and transverse colon, (2) abdominal computed tomography (CT) – colonic wall thickening with intramural calcification and mesenteric venous calcification, (3) barium enema-luminal narrowing, wall rigidity and thumbprinting appearance, (4) superior mesenteric angiography-decreased vascularity of right colon, narrowing or occlusion of the marginal arteries, disturbance of venous return, dilatation and tortuosity of the veins along the vasa recta, (5) colonscopy-dark purple-colored edematous mucosa and prominent submucosal veins, (6) colonscopic biopsy-marked fibrous thickening with hyalinization of mucosal venous wall, narrowing of the lumen but no thrombus. The pathognomonic hallmark for radiological diagnosis of chronic phlebosclerotic ischemic colitis is the vascular calcifications in the colonic wall and mesenteric veins seen on Plain abdominal radiography and abdominal CT.

並列關鍵字

Colitis ischemic ； Colon CT ； Veins Mesenteric ； Veins stenosis or obstruction

國際替代計量

Chronic Phlebosclerotic Ischemic Colitis

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