Chen Ming-Tsung, Yu Sheng-Lan, Yang Tzeng-Huey
Department of RadiologyLoDong Po-Hai Hospital, I-Lan, Taiwan.
Chang Gung Med J. 2010 Sep-Oct;33(5):581-5.
Phlebosclerotic colitis is a rare type of ischemic colitis caused by obstruction of the veins in the intestinal wall and adjacent mesentery, and is most commonly seen in the ascending colon. We report a 56-year-old woman presenting with intermittent abdominal pain and diarrhea for three years. She had a liver abscess and two episodes of pancreatitis during this time and experienced progressive body weight loss. Initial radiologic findings showed multiple tortuous threadlike calcifications in the region of the right side of the colon and transverse colon on plain abdominal radiographs and computed tomography images. A colonoscopy demonstrated brownish-black pigmentation on the right side of the colon with scattered hyperemic patches. The more distal along the colon, the more normal the color of the bowel appeared. Follow-up studies revealed calcifications not only alongside the colonic and mesenteric veins, but also extending into the superior and inferior mesenteric veins. These findings have not been reported previously. As noted in our patient, this disease entity may not be confined to the tributaries of the superior mesenteric vein. The entire colon may be involved in advanced disease.
静脉硬化性结肠炎是一种罕见的缺血性结肠炎，由肠壁和相邻肠系膜的静脉阻塞引起，最常见于升结肠。我们报告一名56岁女性，出现间歇性腹痛和腹泻三年。在此期间，她有肝脓肿和两次胰腺炎发作，并出现进行性体重减轻。最初的放射学检查结果显示，腹部平片和计算机断层扫描图像上，结肠右侧和横结肠区域有多个迂曲的线状钙化。结肠镜检查显示结肠右侧有棕黑色色素沉着，伴有散在的充血斑。沿着结肠越向远端，肠管颜色越正常。随访研究发现，钙化不仅沿结肠和肠系膜静脉分布，还延伸至肠系膜上、下静脉。这些发现以前未曾报道过。正如我们的患者所示，这种疾病实体可能不限于肠系膜上静脉的分支。晚期疾病可能累及整个结肠。
