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CASE REPORT article

Front. Gastroenterol.

Sec. Gastrointestinal Infection

Volume 4 - 2025 | doi: 10.3389/fgstr.2025.1549662

Clinical Challenges in Diagnosing Idiopathic Mesenteric Phlebosclerotic Colitis: Two Case Reports and an Up-to-Date Literature Review

Provisionally accepted
MingYan Shang MingYan Shang 1Liang Yin Liang Yin 1Zhangzhu Li Zhangzhu Li 1Jie Gan Jie Gan 1*Jing Wang Jing Wang 2*
  • 1 Medical Imaging Center, Shandong Provincial Third Hospital, Jinan, China
  • 2 Department of Intelligent Healthcare, Shandong Provincial Third Hospital, Jinan, China

The final, formatted version of the article will be published soon.

    Idiopathic mesenteric phlebosclerotic colitis (IMP) is a rare ischemic colitis primarily affecting the right colon, characterized by mesenteric venous sclerosis and calcification. Its etiology remains unclear, but prolonged use of traditional Chinese herbal medicines, particularly those containing gardeniae fructus, has been suggested as one of several contributing factors, alongside metabolic disorders and potential genetic predispositions. This case report highlights two cases of IMP linked to herbal medicine use, providing insights into its pathogenesis, diagnosis, and management. Both patients were diagnosed with IMP based on CT imaging and histopathology. Management involved discontinuation of herbal treatments, dietary modifications, and controlling metabolic conditions. Both patients had stable outcomes with no disease progression upon follow-up. This case report underscores the importance of considering IMP in patients with unexplained ischemic colitis, particularly those with a history of long-term herbal medicine use. Early intervention, including discontinuation of herbal remedies and management of metabolic factors, is crucial for preventing disease progression. Further research is needed to better understand the pathophysiology of IMP and its relationship with herbal medicine.

    Keywords: :Idiopathic mesenteric phlebosclerosis, Mesenteric vein calcification, case report, Drug-related, Rare gastrointestinal disorders

    Received: 21 Dec 2024; Accepted: 26 Mar 2025.

    Copyright: © 2025 Shang, Yin, Li, Gan and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jie Gan, Medical Imaging Center, Shandong Provincial Third Hospital, Jinan, China
    Jing Wang, Department of Intelligent Healthcare, Shandong Provincial Third Hospital, Jinan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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