Idiopathic myointimal hyperplasia of the mesenteric veins

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.

Idiopathic Myointimal Hyperplasia of the Mesenteric Veins: A Rare Imitator of Inflammatory Bowel Disease

Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare cause of chronic colonic ischemia characterized by intimal smooth muscle proliferation and luminal narrowing of the small to medium sized mesenteric veins. It predominantly affects the rectosigmoid colon in otherwise healthy, middle-aged males. Definitive diagnosis and treatment are surgical; however, patients are frequently misdiagnosed, which often results in a protracted clinical course. We describe a case of IMHMV presenting as left hemicolitis in a 53-year-old male, as well as the endoscopic, histopathologic, and radiographic findings that established the diagnosis.