Hou XL, Chen J, Cui MH, Yang GB. Extensive idiopathic mesenteric phlebosclerosis presenting as intestinal pseudo-obstruction: A case report. World J Clin Cases 2025; 13(25): 105028 [DOI: 10.12998/wjcc.v13.i25.105028]
Corresponding Author of This Article
Mei-Hua Cui, Department of Gastroenterology, Aerospace Center Hospital, No. 15 Yuquan Road, Haidian District, Beijing 100049, China. cuimeih@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Extensive idiopathic mesenteric phlebosclerosis presenting as intestinal pseudo-obstruction: A case report
Xiao-Lin Hou, Jie Chen, Mei-Hua Cui, Gui-Bin Yang
Xiao-Lin Hou, Mei-Hua Cui, Gui-Bin Yang, Department of Gastroenterology, Aerospace Center Hospital, Beijing 100049, China
Jie Chen, Department of Medical Imaging, Aerospace Center Hospital, Beijing 100049, China
Co-corresponding authors: Mei-Hua Cui and Gui-Bin Yang.
Author contributions: Hou XL wrote the original draft of the manuscript; Chen J helped analyze and interpret the imaging findings; Hou XL and Yang GB helped treat the patient and collect the clinical data; Cui MH and Yang GB were equally responsible for revising the manuscript and made equal contributions and as co-corresponding authors of this manuscript. All the authors approved the final version to be submitted.
Informed consent statement: The patient signed an informed consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei-Hua Cui, Department of Gastroenterology, Aerospace Center Hospital, No. 15 Yuquan Road, Haidian District, Beijing 100049, China. cuimeih@sina.com
Received: February 7, 2025 Revised: April 20, 2025 Accepted: May 18, 2025 Published online: September 6, 2025 Processing time: 150 Days and 13.1 Hours
Abstract
BACKGROUND
Idiopathic mesenteric phlebosclerosis (IMP) is a rare condition that causes ischaemic colitis, has various clinical manifestations, and may even be asymptomatic, often resulting in clinical misdiagnosis.
CASE SUMMARY
We report the case of a 44-year-old woman with chief complaints of abdominal pain, vomiting and decreased defecation. One year prior, the patient was asymptomatic and therefore misdiagnosed with inflammatory bowel disease based on incidental findings on an abdominal computed tomography (CT) scan. The present abdominal CT scan revealed an intestinal obstruction, diffuse thickening of the entire colon wall and calcification of the mesenteric and colonic veins. Colonoscopy revealed multiple ulcerations and extensive dark purple discolouration of the oedematous mucosa. Colonic transit studies suggested a decrease in colonic motility. IMP was considered the underlying cause of her pseudoileus, which was potentially linked to her consumption of Chinese medicinal teas for more than 30 years. The patient underwent conservative medical treatment, and her symptoms gradually improved. She exhibited no signs of ileus or other significant discomfort at the outpatient follow-up one year after the discontinuation of Chinese herbal tea consumption.
CONCLUSION
IMP can present with symptoms of pseudoileus as initial complication. Clinicians can use CT and colonoscopy for differential diagnoses.
Core Tip: This case underscores the need for heightened awareness of idiopathic mesenteric phlebosclerosis as a differential diagnosis in patients presenting with symptoms of pseudoileus, particularly those with a history of long-term Chinese herbal medicine use. The characteristic features of colonoscopy and computed tomography scan can help in differential diagnosis when suspecting this disease.
