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Idiopathic myointimal hyperplasia of mesenteric veins depicted by barium enema examination, and conventional and magnifying colonoscopy

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Abstract

A 71-year-old man was admitted to our institution complaining of abdominal pain and constipation. Barium enema examination revealed narrowing, cobble stoning, and longitudinal ulcerations in the sigmoid colon and upper rectum. Conventional colonoscopy, magnifying narrow-band imaging endoscopy, and magnifying chromoendoscopy revealed edematous mucosa, longitudinal ulcerations with luminal narrowing, and multiple pseudopolyps. The histologic examination of the biopsy specimens showed thick-walled (arterialized) capillaries and subendothelial fibrin deposits in the mucosa and submucosa. Based on a preoperative diagnosis of idiopathic myointimal hyperplasia of mesenteric veins (IMHMV), he underwent a laparoscopic resection of the sigmoid colon and upper rectum. The histologic examination of the resected specimens showed marked proliferation of venous walls with marked myointimal thickening and luminal occlusion from the submucosa to the mesentery throughout the entire resected tissue section. The final diagnosis was IMHMV.

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References

  1. Genta RM, Haggitt RC. Idiopathic myointimal hyperplasia of mesenteric veins. Gastroenterology. 1991;101:533–9.

    Article  CAS  Google Scholar 

  2. Yao K, Anagnostopoulos GK, Jawhari AU, et al. Optical microangiography: high-definition magnification colonoscopy with narrow band imaging (NBI) for visualizing mucosal capillaries and red blood cells in the large intestine. Gut Liver. 2008;2:14–8.

    Article  Google Scholar 

  3. Kudo S, Tamura S, Nakajima T, et al. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 1996;44:8–14.

    Article  CAS  Google Scholar 

  4. Martin FC, Yang LS, Fehily SR, et al. Idiopathic myointimal hyperplasia of the mesenteric veins: case report and review of the literature. JGH Open. 2019;4:345–50.

    Article  Google Scholar 

  5. Anderson B, Smyrk TC, Graham RP, et al. Idiopathic myointimal hyperplasia is a distinct cause of chronic colon ischaemia. Colorectal Dis. 2019;21:1073–8.

    Article  CAS  Google Scholar 

  6. Kao PC, Vecchio JA, Hyman NH, et al. Idiopathic myointimal hyperplasia of mesenteric veins: a rare mimic of idiopathic inflammatory bowel disease. J Clin Gastroenterol. 2005;39:704–8.

    Article  Google Scholar 

  7. Almumtin A, Al Sulais E, Elhag MA. Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) with two spontaneous bowel perforations: a case report and literature review. Int J Surg Case Rep. 2021;83:106022.

    Article  Google Scholar 

  8. Xie H, Xu X. Radiological and clinical findings of idiopathic myointimal hyperplasia of mesenteric veins: case report. Medicine (Baltimore). 2021;100:e27574.

    Article  Google Scholar 

  9. Gonai T, Toya Y, Nakamura S, et al. Gastrointestinal: idiopathic myointimal hyperplasia of mesenteric veins. J Gastroenterol Hepatol. 2018;33:1939.

    Article  CAS  Google Scholar 

  10. Yantiss RK, Cui I, Panarelli NC, et al. Idiopathic myointimal hyperplasia of mesenteric veins: an uncommon cause of ischemic colitis with distinct mucosal features. Am J Surg Pathol. 2017;41:1657–65.

    Article  Google Scholar 

  11. Sahara K, Yamada R, Fujiwara T, et al. Idiopathic myointimal hyperplasia of mesenteric veins: rare case of ischemic colitis mimicking inflammatory bowel disease. Dig Endosc. 2015;27:767–70.

    Article  Google Scholar 

  12. Korenblit J, Burkart A, Frankel R, et al. Refractory pancolitis: a novel presentation of idiopathic myointimal hyperplasia of mesenteric veins. Gastroenterol Hepatol (N Y). 2012;8:696–700.

    Google Scholar 

  13. Patel AD, Schneider Y, Saumoy M, et al. Idiopathic myointimal hyperplasia of the mesenteric veins. ACG Case Rep J. 2016;3:e84.

    Article  Google Scholar 

  14. Costa MN, Saiote J, Pinheiro MJ, et al. Segmental colitis caused by idiopathic myointimal hyperplasia of mesenteric veins. Rev Esp Enferm Dig. 2016;108:821–6.

    Article  Google Scholar 

  15. Chudy-Onwugaje K, Ali O, Umoren M. Idiopathic myointimal hyperplasia of the mesenteric veins of the colon. Clin Gastroenterol Hepatol. 2020;18:A19–20.

    Article  Google Scholar 

  16. Conrad K, Roggenbuck D, Laass MW. Diagnosis and classification of ulcerative colitis. Autoimmun Rev. 2014;13:463–6.

    Article  CAS  Google Scholar 

  17. Dambha F, Tanner J, Carroll N. Diagnostic imaging in Crohn’s disease: what is the new gold standard? Best Pract Res Clin Gastroenterol. 2014;28:421–36.

    Article  CAS  Google Scholar 

  18. Magro F, Langner C, Driessen A, et al. European consensus on the histopathology of inflammatory bowel disease. J Crohns Colitis. 2013;7:827–51.

    Article  CAS  Google Scholar 

  19. Gomollón F, Dignass A, Annese V, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohns Colitis. 2017;11:3–25.

    Article  Google Scholar 

  20. Kim SW, Park SH, Park SH, et al (2021). Idiopathic myointimal hyperplasia of mesenteric veins is a peculiar venous ischemia that may be diagnosed before surgery. Dis Colon Rectum. https://doi.org/10.1097/DCR.0000000000002072

  21. Flaherty MJ, Lie JT, Haggitt RC. Mesenteric inflammatory veno-occlusive disease. A seldom recognized cause of intestinal ischemia. Am J Surg Pathol. 1994;18:779–84.

    Article  CAS  Google Scholar 

  22. Al Ansari A, Ahmed S, Mansour E, et al. Idiopathic myointimal hyperplasia of the mesenteric veins. J Surg Case Rep. 2021;1:453.

    Article  Google Scholar 

  23. Yamada K, Hiraki M, Tanaka T, et al. A case of idiopathic myointimal hyperplasia of the mesenteric veins presenting with small bowel obstruction. Surg Case Rep. 2021;7:17.

    Article  Google Scholar 

  24. Nakaya M, Hashimoto H, Nagata R, et al. Enterocolic lymphocytic phlebitis with marked myointimal hyperplasia and perivenous concentric fibrosis. Cardiovasc Pathol. 2019;40:68–71.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Keisuke Kawasaki, Shinichiro Kawatoko, Takehiro Torisu, Katsuki Okamura & Takanari Kitazono

  2. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Shinichiro Kawatoko & Hidetaka Yamamoto

  3. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yusuke Mizuuchi & Masafumi Nakamura

  4. Department of Gastroenterology, Hakujyuji Hospital, Fukuoka, Japan

    Toshimi Iura

  5. Department of Pathology, Hakujyuji Hospital, Fukuoka, Japan

    Hiroshi Ohtani

Authors
  1. Keisuke Kawasaki
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  2. Shinichiro Kawatoko
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  3. Takehiro Torisu
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  4. Yusuke Mizuuchi
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  5. Toshimi Iura
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  6. Hiroshi Ohtani
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  7. Katsuki Okamura
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  8. Hidetaka Yamamoto
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  9. Masafumi Nakamura
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  10. Takanari Kitazono
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Correspondence to Keisuke Kawasaki.

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Kawasaki, K., Kawatoko, S., Torisu, T. et al. Idiopathic myointimal hyperplasia of mesenteric veins depicted by barium enema examination, and conventional and magnifying colonoscopy. Clin J Gastroenterol 15, 734–739 (2022). https://doi.org/10.1007/s12328-022-01647-z

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  • DOI: https://doi.org/10.1007/s12328-022-01647-z

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