China Medical University Faculty of Medicine, Taichung, Taiwan; Department of Internal Medicine, Center for Digestive Medicine, China Medical University Hospital, Taichung, Taiwan; Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Touyuan, Taiwan.
Taiwan Association for the Study of Small Intestinal Diseases (TASSID), Touyuan, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan.
Turk J Gastroenterol. 2023 May;34(5):483-489. doi: 10.5152/tjg.2023.22335.
Idiopathic mesenteric phlebosclerosis is a rare condition with unclear pathogenesis. This study aimed to investigate the clinical features, diagnostic modalities, treatments, and outcomes of idiopathic mesenteric phlebosclerosis patients in Taiwan.
Idiopathic mesenteric phlebosclerosis patients diagnosed by the typical characteristic of tree-like mesenteric venous calcifications on plain abdominal radiography or computed tomography between January 1992 and July 2021 were retrospectively analyzed.
Totally, 36 idiopathic mesenteric phlebosclerosis patients were enrolled (50% females; mean age, 61.6 years). Among the included patients, 26 (72.2%) and 10 (27.7%) were symptomatic and asymptomatic, respectively. Abdominal pain (61.1%) accounted for the majority of all symptoms, followed by fever, diarrhea, and bloody stools. Our results showed that 83.3% of patients had at least 1 risk factor, whereas 16.6% of patients had none. Moreover, among the included patients, 36.1%, 44.4%, 50.0%, 38.8%, and 8.3% had cardiovascular disease, chronic renal disease, cancer, chronic liver disease, and diabetes mellitus, respectively. Our findings showed 94.4% of patients were diagnosed via abdominal computed tomography and plain abdominal radiography, whereas 5.6% of patients were diagnosed via plain abdominal radiography. The ascending colon was the most commonly involved site (100%). Our findings showed that 91.6% of patients experienced good recovery after conservative treatment, except for the 3 who died of sepsis and respiratory failure. By contrast, 8.3% of idiopathic mesenteric phlebosclerosis patients underwent colectomy. The average follow-up duration was 62.5 months.
Idiopathic mesenteric phlebosclerosis remains a rare disease in Taiwan. Plain abdominal radiography and computed tomography can be utilized for establishing a definite diagnosis. Conservative treatment is usually adequate for most patients, with surgical treatment only indicated for severe cases.
特发性肠系膜静脉硬化症是一种发病机制尚不清楚的罕见疾病。本研究旨在探讨台湾特发性肠系膜静脉硬化症患者的临床特征、诊断方式、治疗方法和转归。
回顾性分析 1992 年 1 月至 2021 年 7 月期间，经平片腹部放射影像学或计算机断层扫描检查，以典型的肠系膜静脉树样钙化特征诊断为特发性肠系膜静脉硬化症的患者。
共纳入 36 例特发性肠系膜静脉硬化症患者（50%为女性；平均年龄 61.6 岁）。其中，26 例（72.2%）患者有症状，10 例（27.7%）患者无症状。腹痛（61.1%）是最常见的症状，其次是发热、腹泻和血便。我们的结果显示，83.3%的患者至少存在 1 个危险因素，而 16.6%的患者无任何危险因素。此外，纳入的患者中，分别有 36.1%、44.4%、50.0%、38.8%和 8.3%患有心血管疾病、慢性肾脏病、癌症、慢性肝病和糖尿病。我们发现，94.4%的患者通过腹部计算机断层扫描和腹部平片诊断，5.6%的患者通过腹部平片诊断。升结肠是最常受累的部位（100%）。我们发现，除了 3 例因脓毒症和呼吸衰竭而死亡的患者外，91.6%的患者经保守治疗后恢复良好。相比之下，8.3%的特发性肠系膜静脉硬化症患者接受了结肠切除术。平均随访时间为 62.5 个月。
特发性肠系膜静脉硬化症在台湾仍是一种罕见疾病。腹部平片和计算机断层扫描可用于明确诊断。大多数患者通常采用保守治疗，仅在严重情况下才采用手术治疗。
