Idiopathic Mesenteric Phlebosclerosis with Intestinal Stenosis Refractory to Conservative Treatment on the Sigmoid Colon as the Main Lesion: A Case Report

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  • Hiratsuka Takahiro
    Department of Surgery, Arita Gastrointestinal Hospital Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine Department of Advanced Medical Research and Development for Cancer and Hair [Aderans],Oita University Faculty of Medicine
  • Arakane Yusuke
    Department of Surgery, Arita Gastrointestinal Hospital
  • Shiromizu Akio
    Department of Surgery, Arita Gastrointestinal Hospital
  • Arita Keiko
    Department of Gastroenterology, Arita Gastrointestinal Hospital
  • Nishida Haruto
    Department of Diagnostic Pathology, Oita University Faculty of Medicine
  • Inomata Masafumi
    Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine Department of Advanced Medical Research and Development for Cancer and Hair [Aderans],Oita University Faculty of Medicine

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  • S状結腸を主座とした石灰化を伴わない保存的治療抵抗性特発性腸間膜静脈硬化症の1例

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Abstract

<p>Case: 72-year-old male</p><p>History of present illness: Two months ago, he began to have diarrhea and continuous left lower quadrant pain. One month ago, his family doctor prescribed Shokenchutou (TJ-99) and Keishi-ka-shakuyaku-tou (TJ-60), which he took internally, but his diarrhea worsened to 20 times a day, so he came to our hospital. A lower gastrointestinal endoscopy revealed stenosis of the sigmoid colon with erosions, ulcers, edema, and vasodilation that prevented passage of a scope. Biopsy of the same area revealed nonspecific inflammation, and a diagnosis of stricture-type ischemic colitis was made. He was hospitalized and underwent conservative treatment with fasting, but his symptoms did not improve and so a transverse colostomy was constructed. After 1.5 months, CT and lower gastrointestinal endoscopy revealed reduced edema in the lesion, but the scope was impassable, so a laparoscopic-assisted low anterior resection was performed. Histopathological examination of the resected specimen revealed a diagnosis of idiopathic mesenteric venous sclerosis. Two months after surgery, the colostomy was closed and the patient was discharged from the hospital. Eight months after surgery, the patient is doing well.</p><p>Conclusion: We experienced a case of idiopathic mesenteric venous sclerosis without calcification with a sigmoid colon as the main locus refractory to conservative treatment.</p>

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