Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.8148
Peer-review started: December 3, 2014
First decision: January 8, 2015
Revised: February 6, 2015
Accepted: April 9, 2015
Article in press: April 9, 2015
Published online: July 14, 2015
AIM: To examine the correlation between the severity of venous calcifications and the clinical symptoms of phlebosclerotic colitis.
METHODS: This was a retrospective study. The data, including the numbers of episodes of active disease, were collected from the medical records at Taipei Veterans General Hospital and Wei Gong Memorial Hospital in Taiwan between January 2005 and December 2014. All computed tomography images with or without contrast enhancement were obtained using a multiple detector computed tomography scanner. The scanning range reached from the dome of the diaphragm to the pelvis. The severity of calcification at the tributaries of the portal vein was measured using a four-grade scoring system of the calcification of phlebosclerotic colitis. The episodes of active disease were defined as symptoms of fever, abdominal pain, severe constipation, bowel obstruction, vomiting or diarrhea based on a review of the medical records. Spearman’s correlation analysis was used to examine the correlation between the numbers of episodes of active disease and the severity of the calcification of the mesenteric veins.
RESULTS: More than 3000 cases were reviewed from 2005 to 2014, and a total of 12 patients from Taipei Veterans General Hospital and Wei Gong Memorial Hospital were enrolled according to our inclusion criteria. Among these 12 patients, the mean age of the six males and the six females was 61.8 ± 11.5 years. All patients exhibited typical imaging characteristics, consisting of threadlike calcifications and colonic wall thickening in the standard radiographs and calcifications along the colonic and mesenteric vessels or associated with colonic wall thickening and adjacent fat stranding in the computed tomography images. The median score of the severity of the venous calcifications was 18 ± 13, and the median number of active disease episodes was 1 ± 1.75. Spearman’s correlation analysis revealed that the number of episodes of active phlebosclerotic colitis disease significantly positively correlated with the severity of the calcification of the mesenteric veins (r = 0.619, P < 0.05).
CONCLUSION: The extent of mesenteric venous calcification is strongly associated with the number of episodes of active disease among patients with phlebosclerotic colitis.
Core tip: Phlebosclerotic colitis, which is almost exclusively observed in the Asian population, is a rare condition of ischemic colitis associated with the sclerosis and calcification of the mesenteric venous wall, resulting in the preferential involvement of the right hemicolon and complications during a relatively chronic clinical course. We reviewed the medical records and examined the correlation between the severity of venous calcifications and the clinical symptoms of phlebosclerotic colitis observed on computed tomography images. According to our findings, the extent of mesenteric venous calcifications strongly positively correlates with the number of episodes of active disease.