Idiopathic mesenteric phlebosclerosis missed by a radiologist at initial diagnosis: A case report

BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare type of ischemic colitis characterized by thickening of the wall of the right hemicolon and calcification,sclerosis,and fibrosis of mesenteric veins.The diagnosis of IMP is based on typical clinical features and imaging findings.We report a case of IMP that was initially missed by the radiologist.CASE SUMMARY A 77-year-old woman was admitted to the hospital due to chronic diarrhea for over 2 months.She had been consuming Chinese patent medicines(CPM)containing fructus gardeniae for more than 15 years.Colonoscopy revealed an edematous mucosa,bluish-purple discoloration,erosions,and ulcerations throughout the colorectal area.Abdominal computed tomography(CT)showed diffuse mural thickening of the entire colorectum,with tortuous thread-like calcifications in the right hemicolon,left hemicolon,and rectum.Most of the calcifications were located in the mesenteric vein.The diagnosis of IMP was established based on medical history,colonoscopy,CT findings,and histopathological examination.The patient was treated conservatively with papaverine and rifaximin,and CPM was stopped.Her diarrhea symptoms improved,indicating the effectiveness of the treatment.Over the next several years,she took opium alkaloids for an extended period and did not require hospitalization for the aforementioned gastrointestinal disorder.CONCLUSION IMP is a rare gastrointestinal disease affecting Asian populations,possibly related to long-term herbal medicine intake.Accurate imaging analysis is crucial for diagnosis,but insufficient understanding of the disease can lead to misdiagnosis or missed diagnosis.Treatment strategies should be personalized.

A Study on the Impact of Psychological Counseling for Minor Medical Students in Clinical Teaching and Learning

Objective:To explore the impact of psychological counseling for underage medical students in clinical teaching.Methods:24 of the 48 underage medical students who were interned in our hospital from March 2023 to February 2024 were randomly selected to adopt the teaching management method of one-on-one psychological guidance as the observation group;the remaining 24 adopted the traditional teaching management method as the control group.The observation of the effects of psychological detachment on various aspects of underage medical students allows the determination of whether psychological detachment impacts clinical teaching.Results:The observation group’s theoretical examination scores,skill assessment scores,and departmental performance evaluation scale score excellence rate were higher than the control group’s,with P<0.05 being statistically significant.At the same time,the clinical teaching and teaching management ability of the hospital was also improved.Conclusion:Psychological guidance for underage medical students can not only improve the comprehensive quality of medical students but also improve the teaching level,which is conducive to improving the teaching effect,and it is a clinical teaching mode worth promoting.