Enterocolic Lymphocytic Phlebitis Masquerading as a Malignant Stricture in the Caecum: A Case Report and Literature Review

Abstract

Enterocolic lymphocytic phlebitis (ELP) is an idiopathic form of venous inflammation that is limited to the gastrointestinal tract. It is characterised by inflammation of the veins with no involvement of the arteries. Usually, it presents with gastrointestinal symptoms such as abdominal pain, and imaging may suggest malignancy. The reported case is a 56-year-old female presented with rectal bleeding, abdominal pain and diarrhoea. All blood test results were normal; however, she had an elevated C-reactive protein (CRP) level. Computed tomography colonography showed caecal wall thickening, suggesting caecal malignancy. Following a multidisciplinary discussion, the patient had a right hemicolectomy, and the histology showed no malignancy and typical features of ELP. This is a rare idiopathic form of venous inflammation localised to the gastrointestinal tract, which can occasionally present similarly to bowel malignancy. ELP most commonly presents with abdominal pain, followed by hematochezia and diarrhaea. The duration of symptoms varies widely, from hours to a year. Diagnosis is usually confirmed by histopathological assessment. We present this case and literature review considering its rarity, which adds to the literature on this condition.