Clinical significance of abdominal computed tomography and colonoscopy in the evaluation of phlebosclerotic colitis

Clinical manifestations of phlebosclerotic colitis (PC) exhibit significant variability, necessitating diverse treatment strategies depending on disease severity. However, there is limited research exploring the relationship between imaging findings and disease severity. Hence, this retrospective study aimed to analyze the correlation between computed tomography (CT) findings, colonoscopic features, and disease severity. This study compared the abdominal CT characteristics, colonoscopy findings, and treatment modalities of 45 PC patients. CT images were assessed for the severity of mesenteric venous calcification, maximum colonic wall thickness, number of involved colonic segments, and presence of pericolic inflammation. Colonoscopic images were assessed for dark purple discoloration mucosa, erosive and ulcerative lesions, mucosal edema, luminal narrowing, and the number of involved colonic segments. In addition, patients were categorized into three groups: the observation (n= 15), medical treatment (n= 19), and operation (n= 11) groups. In CT images, a significant difference in pericolic inflammation (p= 0.039) was observed among groups. Further, significant differences in dark purple discoloration mucosa (p= 0.033), erosive or ulcerative lesions (p< 0.001), mucosal edema (p< 0.001), luminal narrowing (p= 0.012), and the number of involved colonic segments (p= 0.001) were observed in colonoscopy. Moreover, we found positive correlations between CT and colonoscopy features. In conclusion, CT manifestations and colonoscopy findings exhibited correlation with disease severity in PC. When limited to one diagnostic tool, observations from that tool can infer potential manifestations of the alternative tool.