CTが治療機転となった漢方薬（山梔子）の服用による腸間膜静脈硬化症の1例

Mesenteric phlebosclerosis associated with the administration of Chinese herbal medicine（Sanshishi）：report of a case and literature review

腸間膜静脈硬化症は腸間膜静脈の硬化に起因した灌流障害による比較的まれな慢性虚血性大腸病変とされている。原因は長らく不明とされてきたが，近年，山梔子を含有する漢方薬の長期服用が有力な原因の一つとして注目されている^1）。今回，画像診断を契機に診断に至った，漢方薬（山梔子）の長期服用が原因と考えられた腸間膜静脈硬化症の1例を経験したため，腸間膜静脈硬化症と山梔子やその主成分であるゲニポシドとの関連について，若干の文献的考察を加えて報告する。

We report a case of mesenteric phlebosclerosis（MP）associated with the administration of Chinese herbal medicine. Abdominal non-enhanced CT showed wall thickening of the colon, pericolonic fat stranding, and linear calcification along the mesentery. The diagnosis of MP was made based on the characteristic CT findings. After discontinuation of the oral administration of Chinese herbal medicine, the patient’s symptoms drastically improved. The cause of MP has long been unknown, but Chinese herbal medicine especially containing Sanshishi have recently been highlighted as one of the main causes of MP. All radiologists should be aware of the administration of Chinese herbal medicine（Sanshishi）, when characteristic CT findings were observed, even if attending physicians were not aware of it. In this article, relationship between MP and herbal medicine was discussed, along with literature review.