Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up
Abstract Background Phlebosclerotic colitis (PC) is a rare form of nonthrombotic colonic ischemia. This retrospective study analyzed the clinical findings and temporal CT changes in 29 PC patients with long-term follow-up. Methods Twenty-nine patients with characteristic CT features of PC collected...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-01-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-022-01159-x |
| _version_ | 1819276345939591168 |
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| author | Sheung-Fat Ko Hong-Hwa Chen Chung-Cheng Huang Li-Han Lin Shu-Hang Ng Yi-Wei Lee |
| author_facet | Sheung-Fat Ko Hong-Hwa Chen Chung-Cheng Huang Li-Han Lin Shu-Hang Ng Yi-Wei Lee |
| author_sort | Sheung-Fat Ko |
| collection | DOAJ |
| description | Abstract Background Phlebosclerotic colitis (PC) is a rare form of nonthrombotic colonic ischemia. This retrospective study analyzed the clinical findings and temporal CT changes in 29 PC patients with long-term follow-up. Methods Twenty-nine patients with characteristic CT features of PC collected between 1997 and 2020 were stratified into the acute abdomen group (AA-group) (n = 10), chronic-progressive group (CP-group) (n = 14) and chronic-stable group (CS-group) (n = 5). Clinical and CT changes during follow-up, comorbidities and final outcomes were compared. Results The AA-group exhibited a significantly thicker colonic wall and more involved segments and pericolic inflammation than the CP-group and CS-group on initial CT (p = < 0.001–0.031). Seven patients in the AA-group who underwent right hemicolectomy had no recurrence during follow-up (mean ± SD, 7.1 ± 3.3 years), and the remaining three patients with renal or hepatic comorbidities who underwent conservative treatment died within 14 days. The CP-group showed significantly higher frequencies of chronic renal failure, urinary tract malignancies and liver cirrhosis than the AA-group (p = 0.005–0.008). In addition, CT follow-up (7.9 ± 4.3 years) showed significant increases in mesenteric venous calcifications, colonic wall thickening and involved colonic segments (p = 0.001–0.008) but conservative treatments were effective. The CS-group remained unchanged for years (8.2 ± 3.9 years). Conclusions Early surgery offered excellent prognosis in PC-related acute abdomen denoted by marked right colonic wall thickening and pericolic inflammation on CT. Conservative treatments with a wait-and-watch strategy were appropriate for CP-PC and CS-PC, albeit CP-PC harbored significant increases in calcifications, colonic wall thickening and affected segments in long-term CT follow-up. |
| first_indexed | 2024-12-23T23:38:45Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-12-23T23:38:45Z |
| publishDate | 2022-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-7e3d6d3b3b7948c0b790a46c43317bc12022-12-21T17:25:47ZengSpringerOpenInsights into Imaging1869-41012022-01-0113111210.1186/s13244-022-01159-xPhlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-upSheung-Fat Ko0Hong-Hwa Chen1Chung-Cheng Huang2Li-Han Lin3Shu-Hang Ng4Yi-Wei Lee5Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineAbstract Background Phlebosclerotic colitis (PC) is a rare form of nonthrombotic colonic ischemia. This retrospective study analyzed the clinical findings and temporal CT changes in 29 PC patients with long-term follow-up. Methods Twenty-nine patients with characteristic CT features of PC collected between 1997 and 2020 were stratified into the acute abdomen group (AA-group) (n = 10), chronic-progressive group (CP-group) (n = 14) and chronic-stable group (CS-group) (n = 5). Clinical and CT changes during follow-up, comorbidities and final outcomes were compared. Results The AA-group exhibited a significantly thicker colonic wall and more involved segments and pericolic inflammation than the CP-group and CS-group on initial CT (p = < 0.001–0.031). Seven patients in the AA-group who underwent right hemicolectomy had no recurrence during follow-up (mean ± SD, 7.1 ± 3.3 years), and the remaining three patients with renal or hepatic comorbidities who underwent conservative treatment died within 14 days. The CP-group showed significantly higher frequencies of chronic renal failure, urinary tract malignancies and liver cirrhosis than the AA-group (p = 0.005–0.008). In addition, CT follow-up (7.9 ± 4.3 years) showed significant increases in mesenteric venous calcifications, colonic wall thickening and involved colonic segments (p = 0.001–0.008) but conservative treatments were effective. The CS-group remained unchanged for years (8.2 ± 3.9 years). Conclusions Early surgery offered excellent prognosis in PC-related acute abdomen denoted by marked right colonic wall thickening and pericolic inflammation on CT. Conservative treatments with a wait-and-watch strategy were appropriate for CP-PC and CS-PC, albeit CP-PC harbored significant increases in calcifications, colonic wall thickening and affected segments in long-term CT follow-up.https://doi.org/10.1186/s13244-022-01159-xMesenteric veins (calcifications)Mesentery (phlebosclerosis)Colitis (phlebosclerosis)Colitis (ischemia)Tomography (X-ray computed) |
| spellingShingle | Sheung-Fat Ko Hong-Hwa Chen Chung-Cheng Huang Li-Han Lin Shu-Hang Ng Yi-Wei Lee Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up Insights into Imaging Mesenteric veins (calcifications) Mesentery (phlebosclerosis) Colitis (phlebosclerosis) Colitis (ischemia) Tomography (X-ray computed) |
| title | Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up |
| title_full | Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up |
| title_fullStr | Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up |
| title_full_unstemmed | Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up |
| title_short | Phlebosclerotic colitis: an analysis of clinical and CT findings in 29 patients with long-term follow-up |
| title_sort | phlebosclerotic colitis an analysis of clinical and ct findings in 29 patients with long term follow up |
| topic | Mesenteric veins (calcifications) Mesentery (phlebosclerosis) Colitis (phlebosclerosis) Colitis (ischemia) Tomography (X-ray computed) |
| url | https://doi.org/10.1186/s13244-022-01159-x |
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