Idiopathic mesenteric phlebosclerosis, rare disease entity causing chronic mesenteric ischemia is a member of non-thrombotic, non-inflammatory stenosis or occlusion of the mesenteric veins. The histologic hallmark is marked fibrous mural thickening and sclerosis of the vessel wall. It is frequently accompanied by calcification in the vessel wall. We report the case of a 61-year-old woman with idiopathic mesenteric phlebosclerosis. To our knowledge, this is the first case reported in Korea.
Calcinosis/diagnosis ; Colitis, Ischemic/diagnosis/etiology ; Colonoscopy ; Female ; Humans ; Mesenteric Vascular Occlusion/*diagnosis/etiology/pathology ; Mesenteric Veins/*pathology ; Middle Aged ; Sclerosis/pathology ; Tomography, X-Ray Computed

Idiopathic mesenteric phlebosclerosis, rare disease entity causing chronic mesenteric ischemia is a member of non-thrombotic, non-inflammatory stenosis or occlusion of the mesenteric veins. The histologic hallmark is marked fibrous mural thickening and sclerosis of the vessel wall. It is frequently accompanied by calcification in the vessel wall. We report the case of a 61-year-old woman with idiopathic mesenteric phlebosclerosis. To our knowledge, this is the first case reported in Korea.
Calcinosis/diagnosis ; Colitis, Ischemic/diagnosis/etiology ; Colonoscopy ; Female ; Humans ; Mesenteric Vascular Occlusion/*diagnosis/etiology/pathology ; Mesenteric Veins/*pathology ; Middle Aged ; Sclerosis/pathology ; Tomography, X-Ray Computed

Ischemic colitis is a condition that usually occurs in the elderly, as a form of vascular disease. However, ischemic colitis also occurs, though rarely, in healthy young adults. Moreover, food supplements containing Ephedra sinica or ma huang have been linked to adverse central nervous and cardiovascular events. A 40-year-old man was admitted to our emergency department after 2 episodes of abdominal pain and bloody diarrhea that lasted 24 hours. His medical history was unremarkable for risk factors of bowel ischemia, except for well-controlled hypertension. However, a weight-loss supplement, Ephedra sinica, had been prescribed for daily use during the previous month. Both abdominal/pelvic computed tomography and colonoscopy revealed findings compatible with ischemic colitis. His conditions spontaneously improved without any serious complications, and he was advised to discontinue the use of herbal medications containing ephedrine. In this paper, we describe a case of ischemic colitis that was potentially linked to the use of ma huang with a review of the relevant literature.
Abdominal Pain/etiology ; Adult ; Colitis, Ischemic/*diagnosis/etiology ; Diarrhea/etiology ; *Dietary Supplements ; Drugs, Chinese Herbal/administration & dosage/adverse effects ; Ephedra sinica/*chemistry ; Humans ; Male

No abstract available.
Aged ; Colitis, Ischemic/complications/*diagnosis/therapy ; Cystitis/*diagnosis/etiology ; Dehydration/etiology ; Diarrhea/etiology ; Female ; Fluid Therapy ; Humans ; Hydronephrosis/*diagnosis/etiology ; Oliguria/etiology ; Predictive Value of Tests ; Radiation Injuries/*diagnosis/etiology ; Tomography, X-Ray Computed

Ischemic colitis is one of the most common intestinal ischemic injury in which more than 90% of patient are over 60 year-old. It results from impaired perfusion of blood to the bowel and is rarely caused by vasculitis such as systemic lupus erythematosus, polyarteritis nodosa, and Takayasu's arteritis. Takayasu's arteritis affects the aortic arch, medium-sized and large arteries but rarely involves inferior mesenteric artery. We report a case of Takayasu's arteritis involving inferior mesenteric artery which developed ischemic colitis in a 70 year old female. To the author's knowledge this is the first case report in Korea. A 70 year old woman who had suffered from Takayasu's arteritis for 5 years was admitted for sudden abominal pain and hematochezia. On sigmoidoscopy, there were multiple segmental longitudinal ulcerations around splenic flexure and diffuse hemorrhagic edematous mucosa from descending colon to sigmoid colon. On abdominal CT angiography, inferior mesenteric artery was not traced. We diagnosed it as ischemic colitis combined with Takayasu's arteritis. After the conservative treatment, abdominal pain and hematochezia disappeared. She was followed up to 2 years without recurrence of symptoms.
Abdominal Pain/diagnosis ; Aged ; Colitis, Ischemic/*diagnosis/etiology/pathology ; Female ; Gastrointestinal Hemorrhage ; Humans ; Imaging, Three-Dimensional ; Sigmoidoscopy ; Takayasu Arteritis/complications/*diagnosis/pathology ; Tomography, Spiral Computed

BACKGROUND/AIMS: In general, ischemic colitis has a very good prognosis. However, there are a lot of controversies in relation to the prognostic factors. The aim of this study was to evaluate risk factors of severe ischemic colitis. METHODS: A retrospective study was undertaken of patients with ischemic colitis hospitalized at the Hanyang University Hospital during the interval 2004-2006. Patients were divided into two groups: those with mild course and those with severe course which led to operation, systemic inflammatory response syndrome, or death. RESULTS: A total of 41 cases (M/F=13/28, mean age=63.8 years) of biopsy proven ischemic colitis were included, of which 31 (75.6%) had a mild course and 10 (24.4%) a severe course. Coexisting medical diseases of patients were hypertension (n=24), diabetes (n=14), end-stage renal disease (n=11), cardiovascular disease (n=5), and malignancy (n=5). Male (p=0.049), alcoholics (p=0.025), end-stage renal disease (p=0.013), LDH (p=0.002), CRP (p=0.014), and peritoneal irritation sign (p=0.001) were the significant risk factors of severe ischemic colitis in univariate analysis. In multivariate logistic regression analysis, end-stage renal disease (p=0.026) was the only significant risk factor of severe ischemic colitis. CONCLUSIONS: Careful attention must be paid to end-stage renal disease patients having ischemic colitis.
Aged ; Colitis, Ischemic/diagnosis/*etiology ; Female ; Humans ; Kidney Failure, Chronic/*complications/diagnosis ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Factors ; Severity of Illness Index