Phlebosclerotic Colitis: Clinical Experience from a Southern Taiwan Medical Center

Purpose. This study aimed to enhance physician awareness of phlebosclerotic colitis (PC) through sharing our clinical experience. Methods. A retrospective review was conducted of 29 patients who were diagnosed as PC at Chi Mei Hospital, Taiwan, between 2017 and 2021. Patients' demographic characteristics, clinical data and treatment results were analyzed. Results. The included patients had a median age of 61 years, range 42 to 77 years. The majority of patients were female (23 cases). Only 11 patients (37.9%, 11/29) had history of long-term use of Chinese herbs or medicinal liquor. The most common symptoms were abdominal pain (100%, 29/29) and nausea/vomiting (51.7%, 15/29), followed by abdominal distension (34.5%, 10/29), and intestinal obstruction (13.8%, 4/29). Varying degrees of calcifications were found along the colon and mesenteric veins in all computed tomography (CT) images. The lesions were all located in the ascending and transverse colon, involving the terminal ileum or whole colon (100%, 29/29). A total of 23 patients underwent colonoscopy with all presenting characteristic dark purple-colored endoscopic findings. Conservative treatment with close follow-up was preferred in our series. Finally, nine cases received colectomy surgery due to failure of conservative treatment, refractory symptoms or colon perforation. Conclusion. PC is an exceptionally rare but characteristic entity with unclear etiopathogenesis. Clinicians should be familiar with the imaging and endoscopy features of PC and radiologists should pay attention to thickening of the colon wall along with the calcifications. Abdominal CT and colonoscopy examinations help to make a definitive clinical diagnosis of PC.

關鍵字

Idiopathic mesenteric phlebosclerosis ； Phlebosclerotic colitis ； Mesenteric vein calcification

並列摘要

目的：本研究目的是通過我們的臨床經驗提高對靜脈硬化性結腸炎的認識。方法：對奇美醫院2017-2021年確診為PC的29例患者進行回顧性分析。分析患者的人口統計學、臨床數據和治療結果。結果：患者的平均年齡為58歲，範圍為42至77歲。大多數患者為女性（23例）。僅有11例（37.9%, 11/29）有長期服用中藥和藥酒史。最常見的症狀是腹痛（100%, 29/29）和噁心／嘔吐（51.7%, 15/29），其次是腹脹（34.5%, 10/29）和腸阻塞（13.7%, 4/29）等。在他們所有的電腦斷層掃描（CT）圖像中都發現了沿結腸和腸系膜靜脈有不同程度的鈣化。病變主要位於升結腸和橫結腸（79.3%, 23/29）。迴腸末端、全結腸受累也有被發現。23名患者接受了大腸鏡檢查，均呈現特徵性的腸黏膜深紫色內視鏡檢查結果。在我們的系列中，首選是保守治療。最終，有9例因保守性是治療失敗、反覆性症狀或結腸穿孔而接受手術治療。結論：靜脈硬化性結腸炎是一種非常罕見但具有特徵性的疾病，發病機制尚不清楚。臨床醫師應熟悉靜脈硬化性結腸炎的影像學和內視鏡特徵，放射科醫師應注意鈣化旁結腸壁的增厚。腹部電腦斷層和大腸鏡檢查可以幫助做出臨床診斷。

並列關鍵字

特發性腸系膜靜脈硬化症；靜脈硬化性結腸炎；腸系膜靜脈鈣化

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