Idiopathic Myointimal Hyperplasia of Mesenteric Veins is a Peculiar Venous Ischemia that may be Diagnosed before Surgery

Abstract Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is caused by proliferation of smooth muscle cells in the wall of small mesenteric veins and venules with accumulation of a proteoglycan matrix leading to a non-thrombotic, non-inflammatory venous occlusion resulting in venous ischemia. IMHMV is a rare and poorly understood disease, with <20 case reports in the literature. The purpose of this report is to describe the case of a 63-year-old man who presented with this condition that resulted in colonic ischemia necessitating surgical resection. The cause of IMHMV in this patient was attributed to a Chinese herbal supplement used for degenerative osteoarthritis of the knees. A brief review of the literature is provided along with the case report.

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The Great IBD Imitator: A Case of Idiopathic Myointimal Hyperplasia of the Mesenteric Veins

The American Journal of Gastroenterology ◽

10.14309/00000434-201710001-01438 ◽

2017 ◽

Vol 112 ◽

pp. S782

Author(s):

David Snell ◽

Shawn L. Shah ◽

Jose Jessurun ◽

Charles Maltz ◽

David Wan

Keyword(s):

Mesenteric Veins

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A Case of Protein C Deficiency Associated with Cerebral Infarction and Obstruction of Deep Leg and Inferior Mesenteric Veins

Psychiatry and Clinical Neurosciences ◽

10.1111/j.1440-1819.1993.tb01837.x ◽

1993 ◽

Vol 47 (4) ◽

pp. 887-892 ◽

Cited By ~ 1

Author(s):

Mitsunori Tsuda ◽

Masao Miyazaki ◽

Takahiro Takada ◽

Yoshiyuki Uda ◽

Shigeki Kuzuhara

Keyword(s):

Cerebral Infarction ◽

Protein C ◽

Protein C Deficiency ◽

Mesenteric Veins

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Gas in the Portal and Inferior Mesenteric Veins Caused by Diverticulitis of the Sigmoid Colon

Radiology ◽

10.1148/114.3.601 ◽

1975 ◽

Vol 114 (3) ◽

pp. 601-602 ◽

Cited By ~ 23

Author(s):

Geoffrey A. Graham ◽

Ralph B. Bernstein ◽

Arthur T. Gronner

Keyword(s):

Sigmoid Colon ◽

Mesenteric Veins

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Pylephlebitis complicating appendicitis and its treatment by ligature of the mesenteric veins

British Journal of Surgery ◽

10.1002/bjs.1800239015 ◽

1935 ◽

Vol 23 (90) ◽

pp. 362-376 ◽

Cited By ~ 4

Author(s):

A. M. Stewart-Wallace

Keyword(s):

Mesenteric Veins

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Cerebral Venous Ischemia by Dural Arteriovenous Fistulas

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2005.02.001 ◽

2005 ◽

Vol 14 (4) ◽

pp. 152-156 ◽

Cited By ~ 3

Author(s):

Hiroyuki Nakase ◽

Yasushi Shin ◽

Kenta Fujimoto ◽

Shoichiro Kawaguchi ◽

Toshisuke Sakaki

Keyword(s):

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Venous Ischemia

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Hydrocortisone decreases apoptosis in jejunum of horses subjected to experimental ischemia and reperfusion

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2011000600002 ◽

2011 ◽

Vol 31 (6) ◽

pp. 471-476 ◽

Cited By ~ 2

Author(s):

Geraldo Eleno S. Alves ◽

Heloisa M.F. Mendes ◽

Tiago G.S. Alves ◽

Rafael R. Faleiros ◽

Anilton C. Vasconcelos ◽

...

Keyword(s):

Cell Death ◽

Time Course ◽

Apoptotic Cell ◽

Treated Group ◽

Apoptotic Cell Death ◽

Apoptotic Cells ◽

Ischemia And Reperfusion ◽

Beneficial Effects ◽

Time Zero ◽

Venous Ischemia

In order to evaluate the effect of hydrocortisone on apoptosis in the jejunum of horses subjected to ischemia and reperfusion, ten horses were paired and grouped into two groups - treated (n=5) and non treated (n=5). Segments of the jejunum were used as controls (C), or as venous ischemia (VIsc), which were subjected to 2h of ischemia followed by 2 or 12h of reperfusion. C samples were collected at time zero (prior to ischemia) and VIsc samples were collected at 2h of ischemia and at 2 and 12h of reperfusion. TUNEL positive apoptotic cells were counted in 10 microscopical fields in deep mucosa from each horse throughout the time course. After 12h of reperfusion, the number of apoptotic cells in treated group were significantly lower than in untreated animals, indicating that hydrocortisone inhibits apoptosis. These results indicate that hydrocortisone has a beneficial effects favoring the maintenance of jejunal integrity in horses with ischemia and reperfusion injuries by preventing apoptotic cell death.

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Study of Dural Arteriovenous Fistula Drains into Leptomeningeal Vein without Sinus Interposition

Interventional Neuroradiology ◽

10.1177/15910199040100s122 ◽

2004 ◽

Vol 10 (1_suppl) ◽

pp. 127-134 ◽

Cited By ~ 6

Author(s):

T. Kawaguchi ◽

M. Nakatani ◽

T. Kawano

Keyword(s):

Emergency Treatment ◽

Superior Sagittal Sinus ◽

Venous Drainage ◽

Craniocervical Junction ◽

Sigmoid Sinus ◽

Arteriovenous Fistulas ◽

Sagittal Sinus ◽

Dural Arteriovenous Fistulas ◽

Cranial Fossa ◽

Venous Ischemia

We evaluated dural arteriovenous fistulas (DAVF) drains into leptomeningeal vein (LMV) without the venous sinus interposition. This type of DAVF contained the extra-sinusal type DAVF and the DAVF with so-called pure leptomeningeal venous drainage (PLMVD). We studied 15 patients with DAVF that flows into LMVD without passing into the sinus. The subjects were 5 patients with DAVF in the anterior cranial fossa, 2 with DAVF in the tentorium cerebelli, and 3 with DAVF in the craniocervical junction as extra-sinusal type DAVF and 3 with DAVF in the transverse sigmoid sinus and 2 with DAVF in the superior sagittal sinus as DAVF with PLMVD. This type appears to take a very aggressive course. The arterial pressure of the shunt is directly applied to LMV, which causes bending and winding of the vein, eventually varices, inducing intracranial haemorrhage or venous ischemia in the LMV reflux area. Emergency treatment should be performed as soon as possible. Although it is recognized that interruption of the draining vein is very effective, treatment methods such as TAE, direct surgery, and g knife treatment, or their combinations should be carefully chosen for each case.

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