Korean J Gastroenterol.  2014 Mar;63(3):183-186. 10.4166/kjg.2014.63.3.183.

Idiopathic Phlebosclerotic Colitis: A Rare Entity of Chronic Ischemic Colitis

• Choi JM
• Lee KN
• Kim HS
• Lee SK
• Lee JG
• Lee SW
• Lee OY
• Choi HS

• KMID: 1730930
• DOI: http://doi.org/10.4166/kjg.2014.63.3.183

Abstract

Colonic wall thickening is frequently encountered in various conditions, from acute or chronic inflammatory disease to colorectal carcinoma. Colonic wall thickening may be accompanied by calcifications in mucinous adenocarcinoma of the colon, leiomyosarcoma of the colon, schistosomiasis japonica, and phlebosclerotic colitis. Phlebosclerotic colitis is a rare entity of chronic ischemic colitis associated with sclerosis and fibrosis of mesenteric veins. Although its development is usually insidious, and, thus its diagnosis can be delayed, characteristic findings in phlebosclerotic colitis are calcifications of mesenteric veins as well as colonic wall thickening with calcifications. We report on a 71-year-old woman who presented with chronic diarrhea and intermittent hematochezia, who was first misdiagnosed as mucinous adenocarcinoma of the colon, but finally diagnosed as a rare entity of chronic ischemic colitis, phlebosclerotic colitis. Differential points of phlebosclerotic colitis from other diseases, including leiomyosarcoma and schistosomiasis japonica, are also described.

Keyword

Ischemic colitis; Mesenteric veins; Sclerosis; Vascular calcification

MeSH Terms

Adenocarcinoma, Mucinous/diagnosis
Calcinosis/pathology
Chronic Disease
Colitis, Ischemic/*diagnosis
Colonic Neoplasms/diagnosis
Colonoscopy
Diagnosis, Differential
Female
Humans
Intestinal Mucosa/pathology
Mesenteric Veins/pathology
Radiography, Abdominal
Sclerosis
Tomography, X-Ray Computed

Figure

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  Fig. 1. Simple radiograph shows linear calcifications in the right abdominal area (arrow).

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  Fig. 2. Abdominal CT shows colonic wall thickenings accompanied by mural and mesenteric venous calcifications in the ascending colon (arrows).

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  Fig. 3. Colonoscopy shows dark purple edematous mucosa with areas of luminal narrowing in the ascending colon. Multiple erosions or ulcerations with surrounding erythema are also noted (arrow).

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  Fig. 4. Microscopic examinations. Marked thickening and calcifications of the colonic mucosal and submucosal layers are noted. Mesenteric veins show an abnormally thickened wall with hyalinization (arrow) (H&E, ×200).

Reference

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