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Updated: Mar 18, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
A Case of Idiopathic Mesenteric Phlebosclerosis with Progressive Intestinal Necrosis
Hajime Kayano1, Eiji Nomura, Shinichiro Hiraiwa
1Department of General and Gastroenterological Surgery Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan. h.kayano@tsc.u-tokai.ac.jp.
Abstract:
The patient was a 39-year-old woman who was referred to our department from her previous doctor with a 2-day history of right abdominal pain. Abdominal computed tomography showed wall thickening associated with calcification in the ascending colon. Contrast enhancement in the same portion of the intestinal wall was rather poor. Fluid accumulation was also seen around the intestine, so emergency surgery was performed under a provisional diagnosis of intestinal necrosis. Intestinal necrosis due to idiopathic mesenteric phlebosclerosis was diagnosed from postoperative histopathological tests. Idiopathic mesenteric phlebosclerosis displays a chronic course and in most cases conservative treatment is indicated. Bowel obstruction is common among patients who require surgical treatment, but rare cases such as the present one are also seen in which intestinal necrosis occurs. In recent years, an association with herbal medicine has been indicated as one potential cause of this disease, and this entity should be kept in mind when patients with acute abdomen and a history of taking herbal medicines are encountered.
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