Case Report
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World J Gastroenterol. May 14, 2014; 20(18): 5561-5566
Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5561
Idiopathic mesenteric phlebosclerosis associated with long-term use of medical liquor: Two case reports and literature review
Fang Guo, Yu-Fen Zhou, Fan Zhang, Fei Yuan, Yao-Zong Yuan, Wei-Yan Yao
Fang Guo, Yu-Fen Zhou, Fan Zhang, Yao-Zong Yuan, Wei-Yan Yao, Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Fei Yuan, Department of Pathology, Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Author contributions: Guo F, Zhou YF and Zhang F collected the data; Yuan F collected pathological materials; Guo F wrote the paper; Yuan YZ and Yao WY proofread the paper.
Correspondence to: Wei-Yan Yao, MD, PhD, Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin 2nd Road, Shanghai 200025, China. yaowymail@sina.com
Telephone: +86-21-64370045 Fax: +86-21-64150773
Received: November 16, 2013
Revised: February 27, 2014
Accepted: March 6, 2014
Published online: May 14, 2014
Abstract

A 62-year-old woman was admitted to our hospital in 2011 because of recurrent abdominal pain, nausea and constipation for six months. Computed tomography enterography (CTE) showed tortuous thread-like calcifications in the ileocolic vein and right colic vein, while colonoscopy revealed purple-blue mucosa extending from the cecum to the splenic flexure. Based on the results of these tests, the patient was diagnosed with idiopathic mesenteric phlebosclerosis (IMP). She had a history of Chinese medical liquor intake for one and a half years and her symptoms subsided after conservative treatment. In 2013, a 63-year-old male patient who presented with recurrent lower right abdominal pain, bloating, melena and diarrhea for fifteen months was admitted to our institution. Colonoscopy and CTE led to the diagnosis of IMP. He also used Chinese medical liquor for approximately 12 years. The patient underwent total colectomy and the postoperative course was uneventful. We searched for previously published reports on similar cases and analyzed the clinical data of 50 cases identified in PubMed. As some of these patients admitted use of Chinese medicines, we hypothesize that Chinese medicines may play a role in the pathogenesis of IMP.

Keywords: Idiopathic mesenteric phlebosclerosis, Chinese medical liquor, Ileus, Colonoscopy, Computed tomography enterography

Core tip: The clinical data of two idiopathic mesenteric phlebosclerosis (IMP) patients in our hospital were collected. Both patients presented with recurrent ileus and displayed typical imaging characteristics such as dark purple mucosa on endoscopy and calcifications in mesenteric veins on computed tomography enterography. Both patients confirmed long-term use of Chinese medical liquor. After discontinuing the product, the first patient received conservative treatment, while the second underwent surgery. To date, both patients remain healthy. Following a literature review, a further 50 cases of IMP were analyzed, and it was concluded that the use of Chinese medicines may play a role in the pathogenesis of IMP.