Mesenteric inflammatory veno-occlusive disease occurring during the course of ulcerative colitis: a case report

Yamada, Yosuke; Sugimoto, Ken; Yoshizawa, Yashiro; Arai, Yoshifumi; Otsuki, Yoshiro; Arai, Tomio; Kobayashi, Yasuyuki; Sato, Yoshihiko; Hosoda, Yoshisuke

doi:10.1186/s12876-018-0737-7

Cited by 5 publications

(8 citation statements)

References 11 publications

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“…The search terms included MIVOD in all fields. Our search identified 30 documents, and 33 cases were extracted [1][2][3][4][5][6][7][8][9][10][11][12][13]. Table 1 summarizes these past cases and our patient's case.…”

Section: Discussionmentioning

confidence: 99%

“…There is often a delay in diagnosis. As shown in Table 1, the prognoses after surgical resections were reported to be good [3,4,6]. It is unclear why the pathological process is localized and why recurrence of MIVOD is seldom observed [6].…”

Section: Discussionmentioning

confidence: 99%

“…MIVOD is used to describe an ischemic injury resulting from phlebitis or venulitis that affects the bowel or mesentery in the absence of arteritis [1,3]. Because of its rarity and frequent confusion with other diseases, MIVOD is difficult to diagnose [4]. MIVOD is also resistant to medical treatment and anticoagulants, and immunoregulatory drugs have proven ineffective for patients with MIVOD [5].…”

Section: Introductionmentioning

confidence: 99%

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Successful surgical management of mesenteric inflammatory veno-occlusive disease

et al. 2020

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Background: The term "mesenteric inflammatory veno-occlusive disease (MIVOD)" is used to describe an ischemic injury resulting from phlebitis or venulitis that affects the bowel or mesentery in the absence of arteritis. MIVOD is difficult to diagnose because of its rarity and frequent confusion with other diseases. The incidence and etiology of MIVOD remain unclear; only a few cases have been reported. We describe a case of the successful surgical management of a patient with MIVOD with characteristic images. Case presentation: A 65-year-old Japanese man visited a hospital with the chief complaint of abdominal pain in January 2018. CT showed edema and thickening of the intestinal wall from the descending colon to the rectum. The patient was admitted to the hospital. Suspected diagnoses were enteritis, ulcerative colitis, amyloidosis, vasculitis, malignant lymphoma, and venous thrombus, but no definitive diagnosis was obtained. The patient was transferred to our hospital for the treatment of stenosis (located from the descending colon to the rectum) and bowel obstruction. An emergency transverse colostomy was performed. The sigmoid colon and mesentery were too rigid and edematous to resect. Colonic hemorrhage occurred 2 weeks after the surgery. With radiology intervention, coiling for the arteriovenous fistula in the descending colon was performed, and hemostasis was obtained. A colonoscopy at 6 months post-surgery showed neither ulceration nor stenosis in the rectum, indicating that the rectum could be preserved in the next surgery. However, severe stenosis in the descending and sigmoid colon remained unchanged. Ten months after the transverse colostomy, we performed a subtotal colectomy and ileorectal anastomosis, and an ileostomy was created. The sigmoid colon and mesentery were not so rigid compared to the first surgery's findings, and we were able to resect intestine and mesentery. Histopathology revealed phlebitis and venulitis, fibrinoid necrosis, and normal arteries, meeting the diagnostic criteria for MIVOD. Postoperatively, the patient showed no recurrence for 8 months. Conclusion: Clinicians should consider MIVOD when examining a patient with intestinal ischemia. When MIVOD is suspected, the patient is indicated for surgery based on an accurate diagnosis and good prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful surgical management of mesenteric inflammatory veno-occlusive disease

et al. 2020

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“…Gastrointestinal symptoms such as abdominal pain, nausea and vomiting, diarrhea, and gastrointestinal bleeding have been reported in some cases [5][6][7][8][9][10][11][12][13]. The small and large intestines are the most common sites of diagnosis [1,9,14], and the disease may resemble ischemic or inflammatory bowel disease (IBD) [6,7].…”

Section: Introductionmentioning

confidence: 99%

Enterocolic Lymphocytic Phlebitis Treated Preoperatively with Biologics and Immunosuppressive Agents

Okano

Yao

Nomura

et al. 2022

Case Reports in Pathology

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Enterocolic lymphocytic phlebitis is phlebitis of unknown etiology in which lymphocytes affect veins without arteries and shows evidence of systemic vasculitis in the intestinal wall and mesentery, mainly in the small intestine and colon. Although patients present with a variety of gastrointestinal symptoms and findings like those of inflammatory bowel disease or ischemic bowel disease, there are no specific findings for enterocolic lymphocytic phlebitis. As a result, a diagnosis tends to be made after surgery. There are few case reports of enterocolic lymphocytic phlebitis, and the impact of chronic courses and immunosuppressive drugs on enterocolic lymphocytic phlebitis is not well known. A 47-year-old man was treated with infliximab and steroids for unexplained ulceration and narrowing of the ileocecal area, which was suspected to be inflammatory bowel disease with atypical findings. Lymphocytic phlebitis was noted in the surgical specimen, and enterocolic lymphocytic phlebitis was diagnosed. No recurrence of enterocolic lymphocytic phlebitis was observed postoperatively. This disease should also be considered among patients with inflammatory bowel disease-like lesions that do not respond to infliximab or steroids.

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“…Ulcerative colitis (UC) is a chronic inflammatory disease, is easy to relapse, and prognosis is poor once there are complications[1]. Patients with UC have mucosal inflammation, which may extend continuously to the entire colon[2].…”

Section: Introductionmentioning

confidence: 99%

Ulcerative colitis complicated with colonic necrosis, septic shock and venous thromboembolism: A case report

Zhu

Sun

2019

WJCC

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BACKGROUND Severe total colonic necrosis, septic shock and venous thromboembolism secondary to ulcerative colitis (UC) are rare and life-threatening. No such severe complications have been reported in the literature. CASE SUMMARY We report a 36-year-old woman who developed total colonic necrosis and septic shock secondary to UC. The patient was treated with emergency surgery because computed tomography showed suspicious perforations. Persistent massive ascites occurred after operation and computed tomography angiography demonstrated portal vein, mesenteric vein and splenic vein thrombosis. The patient was discharged from hospital after active treatment. CONCLUSION Clinicians should pay attention to venous thrombosis, colonic necrosis and septic shock in UC patients. Close observation of surgical indications and timely surgical intervention are the key to reduce mortality and complications in UC.

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Mesenteric inflammatory veno-occlusive disease occurring during the course of ulcerative colitis: a case report

Cited by 5 publications

References 11 publications

Successful surgical management of mesenteric inflammatory veno-occlusive disease

Successful surgical management of mesenteric inflammatory veno-occlusive disease

Enterocolic Lymphocytic Phlebitis Treated Preoperatively with Biologics and Immunosuppressive Agents

Ulcerative colitis complicated with colonic necrosis, septic shock and venous thromboembolism: A case report

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