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- W2054649618 abstract "A 56-year-old woman presented with a 1-week history of progressive abdominal distension and pain. She was afebrile and normotensive. An abdominal examination showed periumbilical tenderness without muscle guarding. Laboratory tests showed a normal leukocyte count but an increased C-reactive protein level (23.2 mg/L). Abdominal radiography showed a dilated ascending colon and small-bowel loops (Figure A, red arrows). Multiple tortuous thread-like calcifications were noted throughout the ascending colon (Figure A, green arrows), as well as along the mesenteric veins (Figure A, yellow arrows). An abdominal computed tomography showed numerous serpiginous calcifications in the tributaries of the superior mesenteric vein (Figure B, yellow arrows; Figure C, yellow arrows). Mural thickening with calcification in the right colon (Figure B, red arrows) and obstruction at the midtransverse colon also were found (Figure C, red arrows). Under the impression of colonic obstruction, an exploratory laparotomy was performed. During surgery, the colonic mucosa was edematous and dark purple (Figure D). The patient underwent an extended right hemicolectomy followed by primary anastomosis and was discharged uneventfully 2 weeks later. The histopathologic examination showed narrowing vessel lumens with fibrous wall thickening (Figure E, red arrows; Figure F, red arrows). Multiple calcifications also were found in the vascular wall (Figure E, yellow arrows; Figure F, yellow arrows). These findings were compatible with phlebosclerotic colitis. At follow-up evaluation 1 year after surgery, she remained asymptomatic without any abdominal pain. Yao et al1Yao T. Iwashita A. Hoashi T. et al.Phlebosclerotic colitis: value of radiography in diagnosis–report of three cases.Radiology. 2000; 214: 188-192Crossref PubMed Scopus (81) Google Scholar coined the term phlebosclerotic colitis in 2000. The condition occurs mainly in patients of Asian background and shows a female predominance. Symptoms include diarrhea, abdominal pain, nausea, vomiting, and tarry stool.2Hu P. Deng L. Phlebosclerotic colitis: three cases and literature review.Abdom Imaging. 2013; 38: 1220-1224Crossref PubMed Scopus (13) Google Scholar Intestinal obstruction and perforation also are seen in some patients.1Yao T. Iwashita A. Hoashi T. et al.Phlebosclerotic colitis: value of radiography in diagnosis–report of three cases.Radiology. 2000; 214: 188-192Crossref PubMed Scopus (81) Google Scholar, 3Kato T. Miyazaki K. Nakamura T. et al.Perforated phlebosclerotic colitis–description of a case and review of this condition.Colorectal Dis. 2010; 12: 149-151Crossref PubMed Scopus (21) Google Scholar Its etiology remains unknown. Kusanagi et al4Kusanagi M. Matsui O. Kawashima H. et al.Phlebosclerotic colitis: imaging-pathologic correlation.AJR Am J Roentgenol. 2005; 185: 441-447Crossref PubMed Scopus (41) Google Scholar thought hypertension of the portal vein would be one cause of this disease, whereas Chang5Chang K.M. New histologic findings in idiopathic mesenteric phlebosclerosis: clues to its pathogenesis and etiology–probably ingested toxic agent-related.J Chin Med Assoc. 2007; 70: 227-235Crossref PubMed Scopus (58) Google Scholar reported that phlebosclerotic colitis may be related to the ingestion of some toxic agents. However, evidence is lacking." @default.
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- W2054649618 date "2014-09-01" @default.
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- W2054649618 title "Phlebosclerotic Colitis Presenting as Intestinal Obstruction" @default.
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- W2054649618 doi "https://doi.org/10.1016/j.cgh.2014.02.018" @default.
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