Idiopathic myointimal hyperplasia of mesenteric veins: Rare case of ischemic colitis mimicking inflammatory bowel disease

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
Kota SaharaTatsuro Yamaguchi

Abstract

Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare and poorly understood ischemic colitis that occurs in the rectosigmoid colon of predominantly young, previously healthy, male patients. A 76-year-old Japanese man presented to our hospital with a 1-year history of worsening diarrhea, lower abdominal pain, and weight loss (-6 kg). Laboratory evaluation revealed white blood cell count of 13 200/μL, C-reactive protein level of 2.0 mg/dL (normal range, 0.0-0.3), and negative results for stool culture (including Clostridium difficile). Colonoscopy showed circumferential and edematous narrowing of the sigmoid colon with deep longitude ulceration. Biopsy was done and examination of the specimen demonstrated no specific ischemia. The patient was treated with bowel rest, antibiotics, and i.v. fluids; however, his symptoms worsened. Finally, sigmoidectomy was carried out. Histological examination demonstrated significant myointimal hyperplasia of mesenteric veins leading to thickening and stenosis of the venous lumen. Therefore, the final diagnosis was IMHMV. Three months following sigmoidectomy, he was asymptomatic.

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Citations

Feb 24, 2016·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Mariana N CostaJaime Ramos
Nov 14, 2016·Annales de pathologie·Aurélie CauchoisSébastien Henno
May 11, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·B AndersonS Sweetser
Jun 24, 2017·World Journal of Gastroenterology : WJG·Zong-Ming ZhangZhao-Hui Lu
Jun 10, 2020·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Felicity C MartinPenelope A McKelvie
May 24, 2016·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Kyung Ho YangIlseon Hwang
Feb 23, 2021·Surgical Case Reports·Takuto YoshidaAkinobu Taketomi

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