• Yang Wen, Ming Zhao, Wei Huang, Songhua Fang, and Chunmiao Lin.
• Departments of Radiology.
• Medicine (Baltimore). 2020 Oct 16; 99 (42): e22813e22813.

RationaleIdiopathic mesenteric phlebosclerosis (IMP) is a rare form of ischemic colitis. It is more common in the Asian population people with Asian ancestry. Disease pathogenesis and etiology are not fully elucidated but may be associated with the long-term intake of toxins and other substances, including Chinese herbs. The disease has typical radiological and endoscopic features. Radiologic examination combined with endoscopy can lead to a conclusive diagnosis.Patient ConcernsWe present 2 cases of IMP: in male patients aged 66 and 79 years. The first patient presented with diarrhea and abdominal pain, and the second patient presented with numbness of limbs and abdominal discomfort. These patients had a history of long-term use of Chinese herbal medicine (CHM).DiagnosisBoth patients were diagnosed with IMP by endoscopy and radiology, and the diagnosis confirmed by biopsy in the first patient.InterventionsThe first patient was advised to stop using CHM. Both patients were given conservative treatment and were followed up regularly.OutcomesSymptoms improved after conservative treatment. The patients had no obvious discomfort during the follow-up period.ConclusionWe suspect that the disease is induced by the long-term use of CHM, and dosage and duration of use may determine disease severity.

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