萬谷 直樹^{1, 2}, 南 康平³, 山本 昇進³, 木村 容子¹, 伊藤 隆¹

Naoki MANTANI^{1, 2}, Kouhei MINAMI³, Nobuyuki YAMAMOTO³, Yoko KIMURA¹, Takashi ITO¹

¹東京女子医科大学東洋医学研究所, ²ベイサイドクリニック, ³丹羽病院

¹Institute of Oriental Medicine, Tokyo Women’s Medical University, School of Medicine, ²Bayside Clinic, ³Niwa Hospital

キーワード : mesenteric phlebosclerosis, ultrasonography, screening, gardenia fruit

山梔子含有漢方薬を長期服用し，山梔子の総服用量が6,300 gに達した無症状の63歳男性．超音波検査で上行結腸壁の肥厚が指摘され，CTや大腸内視鏡で腸間膜静脈硬化症と診断された．超音波検査では，(1)3ヵ月で結腸壁が急に肥厚する像，(2)初期には粘膜下層主体の肥厚から始まる像，(3)結腸壁内や結腸壁外に沿った粒状～線状の高エコー像などの所見が観察された．腸間膜静脈硬化症の超音波像はほとんど報告されておらず，今回の所見の意義や超音波検査がスクリーニング検査として利用できる可能性について議論した．

A 63-year-old man took a Japanese herbal remedy containing sanshishi (gardenia fruit) for a long time. When the total amount of sanshishi reached 6300 grams, he was still asymptomatic, but wall thickness in the ascending colon was observed on ultrasonography. He was then diagnosed with mesenteric phlebosclerosis based on CT and colonoscopy findings. The ultrasonography findings were as follows: (1) The wall thickness quickly progressed after only 3 months; (2) The wall thickness began in a submucosal layer at an early stage; (3) High-echoic spots or lines were observed in the wall and along the ascending colon. There are few reports on ultrasound imaging in mesenteric phlebosclerosis in the literature. We discussed the significance of the findings in this case and the possibility of using ultrasonography in the screening of mesenteric phlebosclerosis.