Hu Yi-Bing, Hu Min-Li, Ding Jin, Wang Qun-Ying, Yang Xiao-Yun
Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China.
World J Clin Cases. 2020 Feb 26;8(4):798-805. doi: 10.12998/wjcc.v8.i4.798.
Mesenteric phlebosclerosis (MP) is a rare disease of the colon. The clinical manifestations of this disease are nonspecific and it may easily be misdiagnosed. We report a case of MP with amyloidosis in the colonic vessel walls in a patient with hypertension who had been consuming Chinese medicinal liquor for 10 years. We also review the relevant literature and summarize the characteristics of MP in patients in mainland China.
A 64-year-old man was referred to our department from his primary hospital because of abdominal pain, diarrhea, and fever for almost 10 d. Computed tomography showed colon wall thickening, with threadlike calcifications in the mesenteric vein in the transverse colon. Colonoscopy revealed purple-blue mucosa with multiple ulcers in the ascending and transverse colon. Biopsy showed thickening and calcification of the vein walls, perivascular and mucosal collagen degeneration, and amyloidosis. The patient had been consuming Chinese medicinal liquor, mainly that made from gardenia fruit, for 10 years. Based on these results, a diagnosis of MP with amyloidosis was made. After conservative treatment, the patient's discomfort subsided and he was followed closely. The use of Chinese herbal medicine was suspected to play a role in the pathogenesis of MP.
The clinical manifestations of MP are nonspecific. Recognition of its typical imaging findings, including multiple calcifications on computed tomography and purple-blue mucosal discoloration on colonoscopy, is vital.
肠系膜静脉硬化（MP）是一种罕见的结肠疾病。该疾病的临床表现不具有特异性，容易被误诊。我们报告一例患有高血压且饮用中药酒10年的患者，其结肠血管壁出现淀粉样变性的MP病例。我们还回顾了相关文献并总结了中国大陆患者MP的特征。
一名64岁男性因腹痛、腹泻和发热近10天从基层医院转诊至我科。计算机断层扫描显示结肠壁增厚，横结肠肠系膜静脉有丝状钙化。结肠镜检查显示升结肠和横结肠黏膜呈紫蓝色，有多处溃疡。活检显示静脉壁增厚、钙化及血管周围和黏膜胶原变性，还有淀粉样变性。该患者饮用中药酒（主要由栀子果实制成）已有10年。基于这些结果，诊断为伴有淀粉样变性的MP。经过保守治疗，患者的不适症状缓解并接受密切随访。怀疑使用中草药在MP的发病机制中起作用。
MP的临床表现不具有特异性。认识其典型的影像学表现至关重要，包括计算机断层扫描上的多处钙化以及结肠镜检查时黏膜呈紫蓝色。
