Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2020; 8(4): 798-805
Published online Feb 26, 2020. doi: 10.12998/wjcc.v8.i4.798
Mesenteric phlebosclerosis with amyloidosis in association with the long-term use of medicinal liquor: A case report
Yi-Bing Hu, Min-Li Hu, Jin Ding, Qun-Ying Wang, Xiao-Yun Yang
Yi-Bing Hu, Min-Li Hu, Jin Ding, Qun-Ying Wang, Xiao-Yun Yang, Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China
Author contributions: Hu YB and Wang QY designed the study; Hu YB and Hu ML drafted and wrote the manuscript; Yang XY and Ding J revised the manuscript critically for intellectual content; All authors gave intellectual input to the study and approved the final version of the manuscript.
Supported by the Science Foundation, Science and Technology Bureau of Jinhua, Zhejiang Province, China, No. 2018-3-011.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qun-Ying Wang, BMed, Doctor, Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China. qunyingwang2018@163.com
Received: December 10, 2019
Peer-review started: December 10, 2019
First decision: December 30, 2019
Revised: January 7, 2020
Accepted: January 11, 2020
Article in press: January 11, 2020
Published online: February 26, 2020
Processing time: 78 Days and 9.3 Hours
Abstract
BACKGROUND

Mesenteric phlebosclerosis (MP) is a rare disease of the colon. The clinical manifestations of this disease are nonspecific and it may easily be misdiagnosed. We report a case of MP with amyloidosis in the colonic vessel walls in a patient with hypertension who had been consuming Chinese medicinal liquor for 10 years. We also review the relevant literature and summarize the characteristics of MP in patients in mainland China.

CASE SUMMARY

A 64-year-old man was referred to our department from his primary hospital because of abdominal pain, diarrhea, and fever for almost 10 d. Computed tomography showed colon wall thickening, with threadlike calcifications in the mesenteric vein in the transverse colon. Colonoscopy revealed purple-blue mucosa with multiple ulcers in the ascending and transverse colon. Biopsy showed thickening and calcification of the vein walls, perivascular and mucosal collagen degeneration, and amyloidosis. The patient had been consuming Chinese medicinal liquor, mainly that made from gardenia fruit, for 10 years. Based on these results, a diagnosis of MP with amyloidosis was made. After conservative treatment, the patient’s discomfort subsided and he was followed closely. The use of Chinese herbal medicine was suspected to play a role in the pathogenesis of MP.

CONCLUSION

The clinical manifestations of MP are nonspecific. Recognition of its typical imaging findings, including multiple calcifications on computed tomography and purple-blue mucosal discoloration on colonoscopy, is vital.

Keywords: Mesenteric phlebosclerosis; Amyloidosis; Medicinal liquor; Case report

Core tip: Mesenteric phlebosclerosis is a rare disease of the colon, characterized by calcification of the mesenteric vein and thickening of the right hemicolon wall, with fibrosis and hyalinization. Mesenteric phlebosclerosis is difficult to diagnose because its etiology and pathophysiology are unclear, and many patients are asymptomatic or present with atypical symptoms. Herein, we report a case of mesenteric phlebosclerosis with amyloidosis in the colonic vessel walls in a 64-year-old man with hypertension who had been consuming Chinese medicinal liquor for 10 years.