Li BJ, Duan CY, Wang YS, Ma XP, Sun LX. Idiopathic mesenteric phlebosclerosis associated with long-term herbal medicine use: A case report. World J Clin Cases 2026; 14(20): 122343 [DOI: 10.12998/wjcc.122343]
Corresponding Author of This Article
Lai-Xia Sun, Department of Preventive Health Care, Shierwei Community Health Service Center, No. 20 Mintai Avenue, Yangzhou 211400, Jiangsu Province, China. lxssewhospital@163.com
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Medicine, General & Internal
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case-report
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Li BJ, Duan CY, Wang YS, Ma XP, Sun LX. Idiopathic mesenteric phlebosclerosis associated with long-term herbal medicine use: A case report. World J Clin Cases 2026; 14(20): 122343 [DOI: 10.12998/wjcc.122343]
World J Clin Cases. Jul 16, 2026; 14(20): 122343 Published online Jul 16, 2026. doi: 10.12998/wjcc.122343
Idiopathic mesenteric phlebosclerosis associated with long-term herbal medicine use: A case report
Bing-Jie Li, Chun-Yan Duan, Yong-Sheng Wang, Xiao-Pu Ma, Lai-Xia Sun
Bing-Jie Li, Yong-Sheng Wang, Division of Thoracic Tumor Multimodality Treatment, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Chun-Yan Duan, Department of Nursing, Shierwei Community Health Service Center, Yangzhou 211400, Jiangsu Province, China
Xiao-Pu Ma, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Xiao-Pu Ma, Department of Gastroenterology, The Affiliated Hospital of Xizang Minzu University, Xianyang 712082, Shaanxi Province, China
Lai-Xia Sun, Department of Preventive Health Care, Shierwei Community Health Service Center, Yangzhou 211400, Jiangsu Province, China
Co-first authors: Bing-Jie Li and Chun-Yan Duan.
Co-corresponding authors: Xiao-Pu Ma and Lai-Xia Sun.
Author contributions: Li BJ and Duan CY designed the study, have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Ma XP and Sun LX drafted the manuscript, have played important and indispensable roles in the manuscript preparation as the co-corresponding authors; Li BJ, Duan CY, Wang YS, Ma XP and Sun LX reviewed the literature and revised the manuscript; and all authors approved the final version.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by Xizang Autonomous Region Natural Science Foundation, No. XZ202401ZR0131.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
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).
Corresponding author: Lai-Xia Sun, Department of Preventive Health Care, Shierwei Community Health Service Center, No. 20 Mintai Avenue, Yangzhou 211400, Jiangsu Province, China. lxssewhospital@163.com
Received: April 17, 2026 Revised: May 20, 2026 Accepted: June 16, 2026 Published online: July 16, 2026 Processing time: 83 Days and 18.3 Hours
Abstract
BACKGROUND
Idiopathic mesenteric phlebosclerosis (IMP) is a rare chronic ischemic colonic disease associated with mesenteric venous sclerosis and calcification, often linked to long-term use of herbal medicines containing gardenia.
CASE SUMMARY
A man in his late 50s presented with a 1-month history of severe diarrhea, right-sided abdominal pain, and weight loss. He had a 20-year history of intermittent herbal medicine use. Laboratory tests showed elevated inflammatory markers. Colonoscopy revealed bluish-purple mucosa with luminal narrowing. Computed tomography demonstrated diffuse colonic wall thickening and characteristic linear calcifications along the mesenteric veins. Histopathology revealed tubular adenoma-like changes without definite malignancy. The patient improved following conservative treatment including discontinuation of herbal medicine.
CONCLUSION
IMP should be considered in patients with chronic gastrointestinal symptoms and a history of long-term herbal medicine use. Recognition of characteristic imaging findings is essential, and careful long-term surveillance is recommended when adenoma-like changes are present.
Core Tip: Idiopathic mesenteric phlebosclerosis should be considered in patients presenting with chronic gastrointestinal symptoms and a history of long-term gardenia-containing herbal medicine use. Characteristic linear mesenteric venous calcifications on computed tomography are the key diagnostic clue. Adenoma-like histological changes may occur but their malignant potential remains uncertain. Conservative management with discontinuation of implicated herbal medicine can achieve favorable outcomes in patients without severe complications. Long-term surveillance is recommended when adenoma-like changes are present.
