Ischemic Colitis From Idiopathic Myointimal Hyperplasia of the Mesenteric Veins in a Post–Liver Transplant Patient

Wong, Rochelle; Westerveld, Donevan; Yeo, Heather; Jessurun, José; Jesudian, Arun

doi:10.14309/crj.0000000000000692

Cited by 5 publications

(5 citation statements)

References 15 publications

(18 reference statements)

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“…In all published cases of IMHMV, patients showed no response to immunosuppression or antibiotics and are ultimately managed with either segmental or total colectomy, on average, 6 months after initial presentation. 5,6 In the case of our patient, the improvement initially seen with steroids was subsequently believed to be subjective and likely due to the symptom-masking effects of glucocorticoids. The diagnosis of IMHMV is most typically made postoperatively by evaluation of gross surgical specimens.…”

Section: Discussionmentioning

confidence: 72%

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Ischemic Colitis Due to Idiopathic Myointimal Hyperplasia of the Mesenteric Veins

et al. 2023

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Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare and poorly understood noninflammatory ischemic colitis. First reported by Genta and Haggitt in 1991, the disease typically presents with chronic abdominal pain, weight loss, and diarrhea with or without hematochezia in middle-aged men. IMHMV is frequently misdiagnosed as an inflammatory bowel disease. The pathophysiology of IMHMV involves the proliferation of the intimal smooth muscle in mesenteric veins leading to bowel ischemia. The etiology of this process remains unknown. There are no good medical therapies for IMHMV, and surgical resection, a curative intervention, is typically required to make the diagnosis. We present the case of a 66-year-old man with IMHMV diagnosed with endoscopic biopsies.

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Section: Discussionmentioning

confidence: 72%

“…The diagnosis of IMHMV is most typically made postoperatively by evaluation of gross surgical specimens. 5–7 Our case is unique in its acute presentation and rapid progression. To our knowledge, this is the only reported case of IMHMV to have such an abrupt and brisk course.…”

Section: Discussionmentioning

confidence: 85%

Ischemic Colitis Due to Idiopathic Myointimal Hyperplasia of the Mesenteric Veins

et al. 2023

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“…This case is noteworthy as it represents one of the rare instances when IMHMV was diagnosed before surgical resection. Prior to this case report, only two cases of preoperatively diagnosed IMHMV have been documented in the literature [14,15].…”

Section: Discussionmentioning

confidence: 99%

Preoperatively Confirmed Idiopathic Myointimal Hyperplasia of the Mesenteric Veins: A Case Report

Kosako Yost,

Salehpour,

Tschirhart

et al. 2024

Galician med. j.

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Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare cause of colonic ischemia. First documented in the literature in 1991, this condition has remained exceedingly rare, with only a limited number of case reports since its initial mention. It involves proliferation of intimal smooth muscle within the mesenteric veins, resulting in colonic ischemia due to venous constriction and non-thrombotic occlusion. Patients experience a prolonged clinical course and adverse outcomes due to its rarity and nonspecific symptoms. The definitive diagnosis is typically confirmed after surgical resection of the affected colon, as initial biopsies are not deep enough to confirm the diagnosis. Histological examination of these biopsies reveals arteriolization of capillaries, subendothelial hyaline deposits, and fibrin thrombi. We present a case of a patient with a one-year history of diarrhea and abdominal pain. Biopsy samples obtained during colonoscopy showed colitis and proliferation of muscularized capillaries, consistent with IMHMV, prior to colon resection. The patient ultimately underwent laparoscopic total abdominal colectomy to the distal one-third of the rectum with end ileostomy. IMHMV is commonly treated surgically and mismanagement of this condition involving corticosteroids and immunomodulatory agents may result in unfavorable outcomes. This case report is one of the few cases of IMHMV diagnosed preoperatively within existing literature, which highlights a rare etiology of nonspecific colitis, emphasizing the critical divergence in its management approach.

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“…The first case had a more rapid time to diagnosis, despite atypical symptoms, with recognition of IMHMV on imaging. Because IMHMV is refractory to medical management [ 6 , 14 ], timely diagnosis may decrease exposure to expensive and ineffective medical therapies. Suspicion or diagnosis of IMHMV should prompt surgical referral.…”

Section: Discussionmentioning

confidence: 99%

Atypical presentation of a rare disorder; idiopathic myointimal hyperplasia of mesenteric veins (IMHMV): Report of two cases

Bhatt,

Moreira,

Shawki

et al. 2023

International Journal of Surgery Case Reports

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Ischemic Colitis From Idiopathic Myointimal Hyperplasia of the Mesenteric Veins in a Post–Liver Transplant Patient

Cited by 5 publications

References 15 publications

Ischemic Colitis Due to Idiopathic Myointimal Hyperplasia of the Mesenteric Veins

Ischemic Colitis Due to Idiopathic Myointimal Hyperplasia of the Mesenteric Veins

Preoperatively Confirmed Idiopathic Myointimal Hyperplasia of the Mesenteric Veins: A Case Report

Atypical presentation of a rare disorder; idiopathic myointimal hyperplasia of mesenteric veins (IMHMV): Report of two cases

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