Abstract
Phlebosclerotic colitis is a rare disease of intestinal ischemia caused by calcified peripheral mesenteric veins and a thickened colonic wall, differentiating it from the typical ischemic colitis. A 68-year-old man who was undergoing hemodialysis presented with hematochezia and abdominal pain. Colonoscopic findings showed typical dark purple-colored edematous mucosa. Linear calcifications in the colon were noted on both a plain abdominal radiolography and abdominal computer tomography. These findings suggested that the patient suffered from phlebosclerotic colitis. Following bowel rest and fluid therapy, there was full recovery. We herein report a rare case of phlebosclerotic colitis in a hemodialysis patient and include a review of the relevant literature.
References
1. Theodoropoulou A, Koutroubakis IE. Ischemic colitis: clinical practice in diagnosis and treatment. World J Gastroenterol. 2008. 14:7302–7308.
2. Brandt LJ, Boley SJ. American Gastrointestinal Association. AGA technical review on intestinal ischemia. Gastroenterology. 2000. 118:954–968.
3. Lindner A, Charra B, Sherrard DJ, Scribner BH. Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Engl J Med. 1974. 290:697–701.
4. Diamond SM, Emmett M, Henrich WL. Bowel infarction as a cause of death in dialysis patients. JAMA. 1986. 256:2545–2547.
5. Koyama N, Koyama H, Hanajima T, Matsubara N, Fujisaki J, Shimoda T. Chronic ischemic colitis causing stenosis, report of a case. Stomach Intestine. 1991. 26:455–460.
6. Oshitani N, Matsumura Y, Kono M, et al. Asymptomatic chronic intestinal ischemia caused by idiopathic phlebosclerosis of mesenteric vein. Dig Dis Sci. 2002. 47:2711–2714.
7. Yoshinaga S, Harada N, Araki Y, et al. Chronic ischemic colonic lesion caused by phlebosclerosis: a case report. Gastrointest Endosc. 2001. 53:107–111.
8. Iwashita A, Yao T, Schlemper RJ, et al. Mesenteric phlebosclerosis: a new disease entity causing ischemic colitis. Dis Colon Rectum. 2003. 46:209–220.
9. Arimura Y, Kondoh Y, Kurokawa S, et al. Chronic ischemic colonic lesion caused by phlebosclerosis with calcification. Am J Gastroenterol. 1998. 93:2290–2292.
10. Seok SJ, Kim KJ, Son BS, et al. Clinical features of ischemic colitis in patients with chronic kidney disease. Korean J Nephrol. 2009. 28:595–602.
11. Vaziri ND, Dure-Smith B, Miller R, Mirahmadi MK. Pathology of gastrointestinal tract in chronic hemodialysis patients: an autopsy study of 78 cases. Am J Gastroenterol. 1985. 80:608–611.
12. Jung HG, Koh JW, Lee MY. A case of idiopathic mesenteric phlebosclerosis. Korean J Gastroenterol. 2008. 52:261–264.
13. Yoshikawa K, Okahisa T, Kaji M, et al. Idiopathic phlebosclerosis: an atypical presentation of ischemic colitis treated by laparoscopic colectomy. Surgery. 2009. 145:682–684.
14. Markos V, Kelly S, Yee WC, Davis JE, Cheifetz RE, Alsheikh A. Phlebosclerotic colitis: imaging findings of a rare entity. AJR Am J Roentgenol. 2005. 184:1584–1586.
15. Clark ET, Gewertz BL. Intermittent ischemia potentiates intestinal reperfusion injury. J Vasc Surg. 1991. 13:601–606.
16. Hinchliffe RJ, Kirk B, Bhattacharjee D, Roe S, Jeffcoate W, Game F. The effect of haemodialysis on transcutaneous oxygen tension in patients with diabetes-a pilot study. Nephrol Dial Transplant. 2006. 21:1981–1983.