Nagata Yutaka, Watanabe Tetsuo, Nagasaka Kazuhiko, Yamada Masaaki, Saito Minoru, Yazaki Toshinori, Komatsu Kenichi, Sano Mika, Asano Koji, Ando Chikao, Taniuchi Norihide
Department of Oriental Traditional Medical Center, Suwa Central Hospital, Japan.
Intern Med. 2016;55(6):573-81. doi: 10.2169/internalmedicine.55.5642. Epub 2016 Mar 15.
Mesenteric phlebosclerosis (MP) is a disease characterized by calcification of the mesenteric vein, which causes chronic mesenteric ischemia. Recently, the long-term intake of gardenia fruit ('Sanshishi' in Japanese) has been attracting attention as a possible cause. Usually, only advanced, severe MP cases get reported. However, we suspected that some latent cases of this disease may exist. We performed this study in order to determine the prediagnostic cases at our outpatient departments of herbal (Kampo) medicine, with particular attention paid to the initial changes, such as any slight color change of the colon, as shown in colonoscopy.
We recommend colonoscopy and computed tomography (CT) scans for patients with a long-term history of taking herbal medicines containing gardenia fruit. Clinical examinations were performed upon receiving patients' consent from December 2013 to November 2014.
Of the 103 patients who took gardenia fruit long-term, 29 agreed to be checked for MP. 14 patients underwent colonoscopy. Four patients were confirmed to have MP due to the presence of fibrotic deposition of the colonic membrane on histological inspection. Twenty-one patients underwent abdominal CT screening. Characteristic calcification of the mesenteric vein was observed on CT scans in 2 patients. All 4 MP patients took Kampo formulas containing gardenia fruit for more than 6.8 years. The other patients did not develop MP, despite long-term gardenia fruit intake.
We detected the latent and undiagnosed MP cases. All diagnoses were made while paying careful attention to any slight changes in colonoscopy and CT scans.
肠系膜静脉硬化（MP）是一种以肠系膜静脉钙化为特征的疾病，可导致慢性肠系膜缺血。最近，长期摄入栀子果实（日语为“山栀子”）作为可能的病因受到关注。通常，只有晚期、严重的MP病例会被报道。然而，我们怀疑可能存在一些该疾病的潜在病例。我们开展这项研究是为了在我们的汉方门诊确定该疾病的预诊断病例，特别关注结肠镜检查中出现的初始变化，比如结肠的任何轻微颜色改变。
对于有长期服用含栀子果实草药病史的患者，我们建议进行结肠镜检查和计算机断层扫描（CT）。在获得患者同意后，于2013年12月至2014年11月进行了临床检查。
103名长期服用栀子果实的患者中，29名同意接受MP检查。14名患者接受了结肠镜检查。经组织学检查发现4名患者因结肠膜存在纤维化沉积而确诊为MP。21名患者接受了腹部CT筛查。CT扫描在2名患者中观察到肠系膜静脉的特征性钙化。所有4名MP患者服用含栀子果实的汉方配方超过6.8年。其他患者尽管长期摄入栀子果实，但未发生MP。
我们检测到了潜在的、未被诊断的MP病例。所有诊断都是在仔细关注结肠镜检查和CT扫描中的任何轻微变化时做出的。
