Case Report
Panniculitis of the Descending Colon Caused by Enterocolic Phlebitis: A Case Report
MANABU SHIRAKI, SHO TAKAGI, MIKA WATANABE,1 YUICHIROU SATO, SEIICHI TAKAHASHI, YOSHITAKA KINOUCHI, SEIICHI ISHII,2 TAKAYUKI MIZOI,2 KENICHI SHIIBA,2 IWAO SASAKI2 and TOORU SHIMOSEGAWA
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1Department of Pathology, Tohoku Medical Hospital, Sendai 980-8574, and 2Division of Gastroenterological Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574
A 73-year-old male was referred to our hospital for abdominal pain, diarrhea and general fatigue lasting for 3 weeks. Physical examination of the abdomen revealed a firm mass in the left abdominal region. Computed tomography revealed a mass around the descending colon. Colonoscopy and barium enema revealed poor extensibility of the lumen with edematous mucosa, and narrowing of the descending colon with rugged mucosal surface. Because of the clinical symptoms and findings, the patient was diagnosed clinically as suffering from panniculitis of the descending colon. He underwent the left hemi-colectomy with side-to-side colo-colostomy after making of a loop ileostomy. Histological analysis of the resected colon showed an infiltration of inflammatory cells, predominantly lymphocytes, into veins and venules of the submucosa, muscularis propria and fat tissue of the colonic mesentery, with an involvement of all layers of the vessel wall. Arteries were escaped from inflammatory changes. The histopathological diagnosis of enterocolic phlebitis and venulitis was made because of these findings.
keywords —— enterocolic phlebitis; ileostomy; panniculitis; mesenteric inflammatory veno-occulusive disease
© 2004 Tohoku University Medical Press
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Tohoku J. Exp. Med., 2004, 202, 299-304
Address for reprints: Manabu Shiraki, Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.
e-mail: sankara@qf6.so-net.ne.jp