Idiopathic myointimal hyperplasia of the mesenteric veins: A systematic review of surgical management

Lincango-Naranjo, Eddy; Cheong, Ju Yong; Prien, Christopher; Connelly, Tara M.; Dominguez, Oscar Hernandez; Tursun, Naz; Líška, Dávid; Lipman, Jeremy M.; Lightner, Amy L.; Keßler, Hermann; Valente, M.; Hull, Tracy L.; Steele, Scott R.; Holubar, Stefan D.

doi:10.1016/j.surg.2023.04.014

Cited by 3 publications

(2 citation statements)

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“…IMHMV is caused by proliferation of intimal smooth muscle of the mesenteric veins leading to venous narrowing and occlusion, ultimately causing colonic venous ischemia [2]. In literature reviews of this diagnosis, males with a median age of 53-62 years are more likely to be affected at a ratio of 2.7:1 to 4.8:1, cardiovascular risk factors are often present, and the rectosigmoid colon is the most affected segment [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Historically, histopathology after surgical resection of the affected colon is the definitive way the diagnosis of IMHMV is made [8]. Surgery is the only known curative treatment, but because of the rarity and overlap of symptoms, treatment with corticosteroids and immunomodulatory agents is often incorrectly initiated, and there can be a diagnostic delay in up to 29% of patients [4,5,9]. We present a case of a 73-year-old man with a one-year history of diarrhea and significant weight loss who was found to have histologically diagnosed IMHMV prior to surgical resection of the colon.…”

Section: Introductionmentioning

confidence: 99%

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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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