Myointimal hyperplasia of mesenteric vein- an experience in a tertiary care centre

Rama Kumari B, Ahluwalia J, Vaiphei K,

Background: Idiopathic myointimal hyperplasia of mesenteric vein (IMHMV) is an extremely rare cause of venous mesenteric ischemia. It is defi ned as non-thrombotic occlusion of the mesenteric veins secondary to myointimal hyperplasia. IMHMV is a poorly understood condition involving the rectosigmoid colon predominantly young previously healthy male individuals Purpose - to analyze surgically resected bowel specimens reported routinely as intestinal ischemia for the presence of features of IMHMV. There were 30 IMHMV of 118 cases that had been reported as intestinal ischemia.

Results: Clinical and laboratory fi ndings in these 30 cases were re-evaluated. Mean age was 41.83±21.67 years and male female ratio was 5:1. Common presenting symptoms were abdominal pain (93.3%), diarrhoea (70%) and rectal bleeding (40%). Left colon was commonest site of involvement followed by right colon and ileum. Unique histological features observed were variable grades of fi brosis with subserosal and submucosal small to medium size veins showing myointimal proliferation. Thirteen of these 30 patients had associated intestinal stress conditions like strictures, torsions, volvulus and intussusceptions. Majority of these patients were investigated further for hypercoagulable states and were documented to be negative.

Conclusion: IMHMV is a selfl imited condition where surgical resection of the affected segment is suffi cient for a defi nitive treatment and needs to be recognized to avoid further unwarranted “management”.

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Published on: Sep 4, 2017 Pages: 74-79

Full Text PDF Full Text HTML DOI: 10.17352/2455-2283.000044
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