Relationship between severity of venous calcifications and symptoms of phlebosclerotic colitis

AIM: To examine the correlation between the severity of venous calcifications and the clinical symptoms of phlebosclerotic colitis.METHODS: This was a retrospective study.The data,including the numbers of episodes of active disease,were collected from the medical records at Taipei Veterans General Hospital and Wei Gong Memorial Hospital in Taiwan between January 2005 and December 2014.All computed tomography images with or without contrast enhancement were obtained using a multiple detector computed tomography scanner.The scanning range reached from the dome of the diaphragm to the pelvis.The severity of calcification at the tributaries of the portal vein was measured using a four-grade scoring system of the calcification of phlebosclerotic colitis.The episodes of active disease were defined as symptoms of fever,abdominal pain,severe constipation,bowel obstruction,vomiting or diarrhea based on a review of the medical records.Spearman's correlation analysis was used to examine the correlation between the numbers of episodes of active disease and the severity of the calcification of the mesenteric veins.RESULTS: More than 3000 cases were reviewed from 2005 to 2014,and a total of 12 patients from Taipei Veterans General Hospital and Wei Gong Memorial Hospital were enrolled according to our inclusion criteria.Among these 12 patients,the mean age of the six males and the six females was 61.8 ± 11.5 years.All patients exhibited typical imaging characteristics,consisting of threadlike calcifications and colonic wall thickening in the standard radiographs and calcifications along the colonic and mesenteric vessels or associated with colonic wall thickening and adjacent fat stranding in the computed tomography images.The median score of the severity of the venous calcifications was 18 ± 13,and the median number of active disease episodes was 1 ± 1.75.Spearman's correlation analysis revealed that the number of episodes of active phlebosclerotic colitis disease significantly positively correlated with the severity of the calcification of the mesenteric veins(r = 0.619,P < 0.05).CONCLUSION: The extent of mesenteric venous calcification is strongly associated with the number of episodes of active disease among patients with phlebosclerotic colitis.

Idiopathic mesenteric phlebosclerosis associated with long-term oral intake of geniposide

BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare disease,and its etiology and risk factors remain uncertain.AIM To investigate the possible influence of Chinese herbal liquid containing geniposide on IMP.METHODS The detailed formula of herbal liquid prescriptions of all patients was studied,and the herbal ingredients were compared to identify the toxic agent as a possible etiological factor.Abdominal computed tomography(CT)and colonoscopy images were reviewed to determine the extent and severity of mesenteric phlebosclerosis and the presence of findings regarding colitis.The disease CT score was determined by the distribution of mesenteric vein calcification and colon wall thickening on CT images.The drinking index of medicinal liquor was calculated from the daily quantity and drinking years of Chinese medicinal liquor.Subsequently,Spearman’s correlation analysis was conducted to evaluate the correlation between the drinking index and the CT disease score.RESULTS The mean age of the 8 enrolled patients was 75.7 years and male predominance was found(all 8 patients were men).The patients had histories of 5-40 years of oral Chinese herbal liquids containing geniposide and exhibited typical imaging characteristics(e.g.,threadlike calcifications along the colonic and mesenteric vessels or associated with a thickened colonic wall in CT images).Calcifications were confined to the right-side mesenteric vein in 6 of the 8 patients(75%)and involved the left-side mesenteric vein of 2 cases(25%)and the calcifications extended to the mesorectum in 1 of them.The thickening of colon wall mainly occurred in the right colon and the transverse colon.The median disease CT score was 4.88(n=7)and the median drinking index was 5680(n=7).After Spearman’s correlation analysis,the median CT score of the disease showed a significant positive correlation with the median drinking index(r=0.842,P<0.05).CONCLUSION Long-term oral intake of Chinese herbal liquid containing geniposide may play a role in the pathogenesis of IMP.