Abstract
Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare cause of chronic ischaemic colitis. We present the case of a 63-year-old man with no prior history of inflammatory bowel disease, who presented with four months of watery diarrhoea with associated weight loss. No evidence of infection was found on microbiological studies. The distal descending colon appeared circumferentially thickened on CT scanning. Endoscopy showed severe superficial ulceration with a cobblestone-like appearance in the sigmoid colon. Three sets of biopsies taken over six weeks showed ulceration and features of ischaemic colitis.
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