Idiopathic myointimal hyperplasia: An unusual cause of colonic ischemia

Abstract

Introduction: Ischemic colitis is a commonly encountered surgical condition with a variety of causes, including atrial fibrillation, atherosclerosis, hypoperfusion, vasculitis, and rarely drug causes such as methamphetamines. Case Report: Here we describe the case of a 47-year-old male who presented with non-specific abdominal symptoms. He was initially treated for severe ulcerative colitis (UC), before biopsies were re-reviewed and specimens showed changes pathognomic for idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV). He underwent surgical resection of affected segments and recovered well. Conclusion: This case illustrates a rare diagnosis presenting with common symptoms and the importance of considering this diagnosis in patients not responding to usual treatment.