Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2008; 14(14): 2272-2276
Published online Apr 14, 2008. doi: 10.3748/wjg.14.2272
Ischemic colitis due to obstruction of mesenteric and splenic veins: A case report
Seong-Su Hwang, Woo-Chul Chung, Kang-Moon Lee, Hyun-Jin Kim, Chang-Nyol Paik, Jin-Mo Yang
Seong-Su Hwang, Hyun-Jin Kim, Department of Radiology, St. Vincent Hospital, the Catholic University, Suwon-si, Gyeonggi-do 442-723, Korea
Woo-Chul Chung, Kang-Moon Lee, Chang-Nyol Paik, Jin-Mo Yang, Department of Internal Medicine, St. Vincent Hospital, the Catholic University, Suwon-si, Gyeonggi-do 442-723, Korea
Author contributions: Hwang SS and Chung WC contributed equally to this work; Lee KM, Paik CN and Yang JM provided clinical advice; Kim HJ interpreted radiologic studies; Hwang SS and Chung WC wrote the paper.
Correspondence to: Woo-Chul Chung, MD, Department of Internal Medicine, St. Vincent’s Hospital, The Catholic University, 93 ji-dong, Paldal-gu, Suwon-si, Gyunggi-do 442-723, Korea. jwchulkr@yahoo.co.kr
Telephone: +82-31-2497137
Fax: +82-31-2538898
Received: September 27, 2007
Revised: December 10, 2007
Published online: April 14, 2008
Abstract

Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.

Keywords: Ischemic colitis; Mesenteric vein; Splenic vein