Wang Jialiang, Shao Jun, Lu Helei, Wang Bingyi, Chen Ji
Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200336, China.
Am J Transl Res. 2021 Nov 15;13(11):13156-13166. eCollection 2021.
This research is both a case study and a systematic literature review. Our goal was to learn more about the pathophysiology, clinical features, and therapy options for idiopathic mesenteric phlebosclerosis (IMP).
A case of IMP was treated by surgery in our department. Combined with the data of 240 cases of IMP retrieved from PubMed and Wanfang Data, we conducted a systematic review of this less well-known disease.
These 240 cases of IMP mainly occurred in East Asia. Among the patients, 78.7% of them had a history of herbal medicine consumption; 15.2% had no obvious symptoms and their diagnosis was confirmed through characteristic CT findings and colonoscopic manifestations; 58.4% were cured by conservative treatment; 41.6% had severe symptoms and underwent surgical treatment. Additionally, more patients treated with surgical treatment had lesions involving the cecum (59/82 vs. 53/115, =0.0003) and sigmoid colon (20/82 vs. 10/115, =0.0025) compared with those treated conservatively.
The occurrence of IMP is associated with the long-term consumption of herbal medicines. Early diagnosis of IMP could be determined by CT and colonoscopy and conservative or surgical treatment was chosen based on of the severity of the condition (e.g., the involved bowel segment).
本研究既是一项病例研究，也是一项系统的文献综述。我们的目标是更多地了解特发性肠系膜静脉硬化（IMP）的病理生理学、临床特征和治疗选择。
我们科室对1例IMP患者进行了手术治疗。结合从PubMed和万方数据检索到的240例IMP病例的数据，我们对这种鲜为人知的疾病进行了系统评价。
这240例IMP病例主要发生在东亚。在这些患者中，78.7%有服用草药的病史；15.2%没有明显症状，通过特征性CT表现和结肠镜表现确诊；58.4%通过保守治疗治愈；41.6%症状严重，接受了手术治疗。此外，与保守治疗的患者相比，接受手术治疗的患者中累及盲肠（59/82对53/115，P=0.0003）和乙状结肠（20/82对10/115，P=0.0025）的病变更多。
IMP的发生与长期服用草药有关。IMP的早期诊断可通过CT和结肠镜检查确定，并根据病情严重程度（如受累肠段）选择保守或手术治疗。
