Unusual mesenteric fibromuscular dysplasia– a rare cause for chronic intestinal ischaemia: Figure 1

Chaturvedi, Rachana; Vaideeswar, Pradeep; Joshi, Abhishek; Pandit, Shobhana P.

doi:10.1136/jcp.2007.049569

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…FMD can be clinically symptomatic or asymptomatic, and its haemodynamics can be variably affected, which mainly depends on the distribution of the involved vessels and the type and severity of the disease. FMD involving the mesenteric arteries is fairly rare [ 7 , 8 ], and the clinical manifestations of the disease can be postprandial abdominal pain, mesenteric ischaemia, abdominal distension, abdominal vascular murmur, and multiple intestinal mucosa or focal ulcers. Furthermore, continuous or disordered adventitial and periadventitial smooth muscle proliferation can be seen in the histopathological examination of the involved mesenteric arteries and submucosa [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…FMD involving the mesenteric arteries is fairly rare [ 7 , 8 ], and the clinical manifestations of the disease can be postprandial abdominal pain, mesenteric ischaemia, abdominal distension, abdominal vascular murmur, and multiple intestinal mucosa or focal ulcers. Furthermore, continuous or disordered adventitial and periadventitial smooth muscle proliferation can be seen in the histopathological examination of the involved mesenteric arteries and submucosa [ 7 ]. It is worth noting that patients with FMD of the mesenteric artery can present with an acute abdomen, but case reports of patients who have a long medical history and undergo multiple bowel resections are rare.…”

Section: Discussionmentioning

confidence: 99%

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Fibromuscular dysplasia of mesenteric arteries: a rare cause of multiple bowel resections—a case report and literature review

Yang

Jia

et al. 2021

BMC Gastroenterol

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Background Fibromuscular dysplasia (FMD) is a type of unexplained nonatherosclerotic vascular disease that usually involves the renal and internal carotid arteries and rarely involves the mesenteric artery. Mesenteric artery FMD is difficult to distinguish from Crohn’s disease (CD) and Behcet’s disease (BD) solely based on symptoms. Patients with mesenteric artery FMD can present with an acute abdomen, but case reports of patients who have a long medical history and undergo multiple bowel resections are extremely rare. Case presentation The patient was a 45-year-old woman with an 11-year history of intermittent lower abdominal pain and fever. At the age of 34 years, she underwent right hemicolectomy and appendectomy due to an acute abdomen. She suffered from oral ulcers between 34 and 36 years old. A clinical diagnosis of presumed CD was made by the age of 41, and she was treated with mesalazine; however, the effect was poor. At the age of 42, she came to our centre, and based on her atypical symptoms and examination results, we thought she had CD. Hence, she was treated with glucocorticoids for 3 years. However, when she was 45, due to steroid dependence, thalidomide tablets were added. Unfortunately, she suffered from another episode of intestinal obstruction. Therefore, she underwent enterectomy. The postoperative histopathological diagnosis was mesenteric artery FMD. She no longer underwent pharmacotherapy after the surgery. Although she did not have any of her previous symptoms and postoperative colonoscopy showed no signs of recurrence, splenomegaly and abnormal routine blood results were still present. Conclusions Patients with mesenteric artery FMD can present with an acute abdomen. In addition, the symptoms and endoscopic manifestations of mesenteric artery FMD may appear similar to CD and BD. Hence, it is difficult to make a clear clinical diagnosis and proceed with treatment. Mesenteric artery FMD often requires surgical pathology to confirm its diagnosis. For patients who suffer from this disorder, surgery may be the best choice to improve the patient’s quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fibromuscular dysplasia of mesenteric arteries: a rare cause of multiple bowel resections—a case report and literature review

Yang

Jia

et al. 2021

BMC Gastroenterol

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“… a Chaturvedi (2008) [ 43 ], and Cormier (2005) [ 7 ] b Smaller arteries are specified only in the absence of Celiac, SMA and IMA trunk involvement SMA superior mesenteric artery, IMA inferior mesenteric artery …”

Section: Discussionmentioning

confidence: 99%

Massive mesenteric panniculitis due to fibromuscular dysplasia of the inferior mesenteric artery: a case report

2015

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BackgroundFibromuscular dysplasia (FMD) is a nonatheromatous, noninflammatory arterial disorder of unknown etiology resulting in vessel stenosis and/or aneurysm formation. The renal and cephalocervical (mainly carotid arteries) arterial beds are classically involved; involvement of visceral arteries is rare. Mesenteric panniculitis (MP) is an inflammatory process of mesenteric fat considered to be of unknown etiology. The majority of cases involve the small bowel mesentery; colorectal MP is rare. To our knowledge, no example of MP due to FMD has been described.Case presentationA 52 year old man presented with steadily worsening lower abdominal pain. Investigation revealed ischemic rectosigmoid mucosa associated with a large mesenteric mass of unknown nature. Angiography showed the disease was limited to the distribution of the inferior mesenteric artery. Subsequent symptoms of large bowel obstruction necessitated a left hemicolectomy. Pathologic examination showed bowel wall necrosis and massive panniculitis of the rectosigmoid due to FMD. Subsequent angiographic imaging of other vascular beds was negative.ConclusionsSeveral features of this case are noteworthy: FMD limited to the inferior mesenteric artery has not been previously reported, FMD has not previously been implicated as a cause of MP, and the massive extent of panniculitis. An accompanying literature review of cases of visceral FMD, traditionally believed to almost exclusively affect females, highlights a greater than anticipated number of males (33 %), and a gender difference regarding concomitant involvement of cephalocervical and/or renal vascular beds (32 % in males versus 80 % in females). The latter observation may have implications regarding the value of radiologic screening of other vascular beds, particularly in asymptomatic males, in patients presenting with visceral artery FMD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-015-0303-5) contains supplementary material, which is available to authorized users.

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Mimics of Crohn's Disease

Gupta

Allegretti

2022

Gastroenterology Clinics of North America

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Unusual mesenteric fibromuscular dysplasia– a rare cause for chronic intestinal ischaemia: Figure 1

Cited by 7 publications

References 3 publications

Fibromuscular dysplasia of mesenteric arteries: a rare cause of multiple bowel resections—a case report and literature review

Fibromuscular dysplasia of mesenteric arteries: a rare cause of multiple bowel resections—a case report and literature review

Massive mesenteric panniculitis due to fibromuscular dysplasia of the inferior mesenteric artery: a case report

Mimics of Crohn's Disease

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