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Updated: Aug 10, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Idiopathic Mesenteric Phlebosclerosis: A Single-Institute Experience in Taiwan
Jen-Wei Chou1, Chia-Hsi Chang2, Yi-Hua Wu3
1China 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.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Insights
Idiopathic mesenteric phlebosclerosis is a rare condition. Most patients recover with conservative treatment, but severe cases may require surgery. Diagnosis is aided by imaging like CT scans.
Area of Science:
- Gastroenterology
- Radiology
- Vascular Medicine
Background:
- Idiopathic mesenteric phlebosclerosis is a rare condition with an unknown cause.
- This study focuses on patients in Taiwan.
Purpose of the Study:
- To investigate the clinical features, diagnostic methods, treatments, and outcomes of idiopathic mesenteric phlebosclerosis.
- To provide insights into this rare vascular condition.
Main Methods:
- Retrospective analysis of 36 patients diagnosed between 1992 and 2021.
- Diagnosis confirmed by tree-like mesenteric venous calcifications on radiography or CT scans.
Main Results:
- Most patients (72.2%) were symptomatic, with abdominal pain being the most common symptom.
- Common comorbidities included cardiovascular disease (36.1%) and chronic renal disease (44.4%).
- Diagnosis was primarily achieved through abdominal CT and radiography (94.4%).
- Over 91.6% of patients had good recovery with conservative treatment; 8.3% required colectomy.
Conclusions:
- Idiopathic mesenteric phlebosclerosis is rare in Taiwan.
- Plain abdominal radiography and CT scans are effective diagnostic tools.
- Conservative management is typically sufficient, with surgery reserved for severe cases.
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