Abstract
In 1991, Genta and Haggitt described four patients with segmental ischemic colitis caused by idiopathic myointimal hyperplasia in the small mesenteric veins (IMHMV). There are now 33 published cases of IMHMV in the literature; however, this condition is still sufficiently rare that it poses a diagnostic challenge to pathologists and clinicians and is often clinically or histologically confused with inflammatory bowel disease (IBD) or ischemic colitis. IMHMV is characterized by intimal smooth muscle hyperplasia resulting in thickened small and medium‐sized mesenteric veins (with arterial sparing). Clinically, it presents with symptoms that mimic IBD, such as bloody diarrhea, abdominal pain, and weight loss. Surgical resection appears to be curative. The present case describes a 63‐year‐old Vietnamese man with cardiovascular risk factors who was diagnosed with IMHMV after many months of severe symptoms. A review of the current literature follows the case report.
Highlights
In 1991, Genta and Haggitt described four patients with segmental ischemic colitis caused by idiopathic myointimal hyperplasia in the small mesenteric veins (IMHMV)
A 63-year-old Vietnamese man was electively admitted to a tertiary hospital in Melbourne after undergoing an outpatient colonoscopy to investigate progressive bloody diarrhea
One vein showed evidence of recanalization consistent with previous thrombosis. These changes were those of ischemic colitis associated with myointimal hyperplasia of mesenteric veins
Summary
Idiopathic myointimal hyperplasia of the mesenteric veins: Case report and review of the literature. Felicity C Martin,* Linda S Yang,* Sasha R Fehily,* Basil D’Souza,† Allan Lim‡ and Penelope A McKelvie‡. Departments of *Gastroenterology, †Colorectal Surgery and ‡Pathology, St Vincent’s Hospital, Fitzroy, Victoria, Australia. Colitis, idiopathic myointimal hyperplasia of mesenteric veins, ischemia, review. Declaration of conflict of interest: The authors declare that they have no conflicts of interest. Author contribution: FM undertook the review of the literature and writing of the manuscript. LY, SF, and BD contributed to the writing of the manuscript and overall planning of the case report and review. AL contributed the macroscopic images and some of the microscopic images for this case. PM contributed to the writing of the manuscript, the histopathology descriptions and pathologic discussion
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