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Idiopathic mesenteric phlebosclerosis treated with laparoscopic subtotal colectomy: A case report
Jun Takahashi1, Yasuyuki Miyakura1, Ryo Maemoto1
1Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Asian Journal of Endoscopic Surgery
|June 27, 2019
Summary
Idiopathic mesenteric phlebosclerosis, a rare cause of chronic intestinal ischemia, was treated with laparoscopic subtotal colectomy. Comprehensive imaging and colonoscopy are crucial for preoperative assessment of the affected area.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Abdominal Imaging
Background:
- Idiopathic mesenteric phlebosclerosis is a rare condition causing chronic intestinal ischemia.
- It involves calcification and obstruction of mesenteric veins, leading to reduced blood flow to the intestines.
Observation:
- A 68-year-old Japanese woman presented with recurrent abdominal pain after long-term use of Chinese herbal medicine.
- Abdominal CT revealed right colon wall thickening and superior mesenteric vein calcification.
- Colonoscopy showed cyanotic mucosa from the cecum to the sigmoid colon, indicating extensive distal colon involvement.
Findings:
- Despite discontinuing the herbal medicine, the patient's symptoms persisted.
- Laparoscopic subtotal colectomy was performed to address the chronic intestinal ischemia.
- Preoperative evaluation utilizing colonoscopy, CT, and contrast enema was essential for defining the surgical scope.
Implications:
- This case underscores the importance of thorough preoperative assessment in managing idiopathic mesenteric phlebosclerosis.
- Accurate delineation of the affected bowel segment is critical for successful surgical intervention.
- Multimodal imaging and endoscopic evaluation aid in surgical planning for this rare vascular condition.
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