特发性肠系膜静脉硬化性肠炎是一种罕见的肠道缺血性疾病,临床表现缺乏特异性,肠镜提示以右半结肠缺血为主,CT的特征是肠系膜静脉及其属支线性钙化。目前其病因和发病机制尚不清楚,可能与京尼平对血管壁的损伤有关。总结本例患者的诊治经验有助于提高临床医生对特发性肠系膜静脉硬化性肠炎的认识,降低漏诊率。
Idiopathic mesenteric phlebosclerosis is a rare intestinal ischemic disease with non-specific clinical manifestations. Colonoscopy typically shows ischemia in the right colon, and CT scans typically reveal linear calcification in the mesenteric veins and their branches. While the exact cause and mechanism of the disease are not yet clear, there is some evidence suggesting a link to the damage to the vessel wall caused by geniposide. Sharing the diagnostic and treatment experience of this patient can help raise clinical awareness of idiopathic mesenteric phlebosclerosis, leading to fewer misdiagnoses.
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