Choi Jong Min, Lee Kang Nyeong, Kim Hae Su, Lee Sang Ki, Lee Jung Gyu, Lee Sung Won, Lee Oh Young, Choi Ho Soon
Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea.
Korean J Gastroenterol. 2014 Mar 25;63(3):183-6. doi: 10.4166/kjg.2014.63.3.183.
Colonic wall thickening is frequently encountered in various conditions, from acute or chronic inflammatory disease to colorectal carcinoma. Colonic wall thickening may be accompanied by calcifications in mucinous adenocarcinoma of the colon, leiomyosarco-ma of the colon, schistosomiasis japonica, and phlebosclerotic colitis. Phlebosclerotic colitis is a rare entity of chronic ischemic colitis associated with sclerosis and fibrosis of mesenteric veins. Although its development is usually insidious, and, thus its diagnosis can be delayed, characteristic findings in phlebosclerotic colitis are calcifications of mesenteric veins as well as colonic wall thickening with calcifications. We report on a 71-year-old woman who presented with chronic diarrhea and intermittent hematochezia, who was first misdiagnosed as mucinous adenocarcinoma of the colon, but finally diagnosed as a rare entity of chronic ischemic colitis, phlebosclerotic colitis. Differential points of phlebosclerotic colitis from other diseases, including leiomyosarcoma and schistosomiasis japonica, are also described.
结肠壁增厚在各种情况下都很常见,从急性或慢性炎症性疾病到结直肠癌。结肠壁增厚可能伴有结肠黏液腺癌、结肠平滑肌肉瘤、日本血吸虫病和静脉硬化性结肠炎中的钙化。静脉硬化性结肠炎是一种罕见的慢性缺血性结肠炎,与肠系膜静脉的硬化和纤维化有关。虽然其发展通常较为隐匿,因此诊断可能会延迟,但静脉硬化性结肠炎的特征性表现是肠系膜静脉钙化以及伴有钙化的结肠壁增厚。我们报告了一名71岁女性,她表现为慢性腹泻和间歇性便血,最初被误诊为结肠黏液腺癌,但最终被诊断为一种罕见的慢性缺血性结肠炎——静脉硬化性结肠炎。文中还描述了静脉硬化性结肠炎与其他疾病(包括平滑肌肉瘤和日本血吸虫病)的鉴别要点。