Año 2016 / Volumen 108 / Número 12
Caso Clínico
Segmental colitis caused by idiopathic myointimal hyperplasia of mesenteric veins

821-826

DOI: 10.17235/reed.2016.4051/2015

Mariana N. Costa, Joana Saiote, Maria José Pinheiro, Pedro Duarte, Teresa Bentes, Mário Ferraz Oliveira, Jaime Ramos,

Resumen
Diseases causing colonic ischemia may be mistaken with other causes of segmental colitis such as inflammatory bowel disease, especially in young patients. The authors present the case of a 47-year-old male with severe proctosigmoiditis. Assessment excluded infectious causes, thrombophilia and systemic vasculitis. The initial histological specimen was suggestive of inflammatory bowel disease and therapy was initiated with intravenous steroids and, at day 5, infliximab, with no response. The patient was proposed for surgery. Pathological examination of the surgical specimen revealed an idiopathic myointimal hyperplasia of mesenteric veins, a rare entity exhibiting necrotizing phlebitis with rapid progression to segmental necrosis in the rectosigmoid colon. In this paper the authors discuss the differential diagnosis of proctosigmoiditis in young ages and the approach to this exceptionally rare ischemic entity.
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Bibliografía
1. Grendell JH, Ockner RK. Mesenteric venous thrombosis. Gastroenterology 1982;82:358–72.
2. Hunter GC, Guernsey JM. Mesenteric ischemia. Med Clin North Am 1988;72:1091–115.
3. Abu-Alfa AK, Ayer U, West AB. Mucosal biopsy findings and venous abnormalities in idiopathic myointimal hyperplasia of the mesenteric veins. Am J Surg Pathol 1996;20:1271–8.
4. Genta RM, Haggitt RC. Idiopathic myointimal hyperplasia of mesenteric veins. Gastroenterology 1991;101:533–9.
5. Brandt LJ, Boley SJ. AGA technical review on intestinal ischemia. American Gastrointestinal Association. Gastroenterology 2000;118:954–68.
6. Feuerstadt P, Brandt LJ. Colon Ischemia: Recent Insights and Advances. Curr Gastroenterol Rep 2010;12:383–90.
7. Hwang S-S, Chung W-C, Lee K-M et al. Ischemic colitis due to obstruction of mesenteric and splenic veins: a case report. World J Gastroenterol 2008;14:2272–6.
8. Kao PC, Vecchio JA, Hyman NH et al. Idiopathic myointimal hyperplasia of mesenteric veins: a rare mimic of idiopathic inflammatory bowel disease. J Clin Gastroenterol 2005;39:704–8.
9. Mizoshita T, Tanida S, Joh T. A case of punched-out ulcer occurring in the rectosigmoid colon with sudden onset of bloody stools. Gastroenterology 2011;141:e9–10.
10. Savoie LM, Abrams A V. Refractory proctosigmoiditis caused by myointimal hyperplasia of mesenteric veins: report of a case. Dis Colon Rectum 1999;42:1093–6.
11. Lavu K, Minocha A. Mesenteric inflammatory veno-occlusive disorder: a rare entity mimicking inflammatory bowel disorder. Gastroenterology 2003;125:236–9.
12. García-Castellanos R, López R, de Vega VM et al. Idiopathic myointimal hyperplasia of mesenteric veins and pneumatosis intestinalis: a previously unreported association. J Crohns Colitis 2011;5:239–44.
13. Chiang C-K, Lee C-L, Huang C-S et al. A rare cause of ischemic proctosigmoiditis: idiopathic myointimal hyperplasia of mesenteric veins. Endoscopy 2012;44 (Suppl 2):E54–5.
14. Feo L, Cheeyandira A, Schaffzin DM. Idiopathic myointimal hyperplasia of mesenteric veins in the elderly. Int J Colorectal Dis 2013;28:433–4.
15. Korenblit J, Burkart A, Frankel R et al. Refractory pancolitis: a novel presentation of idiopathic myointimal hyperplasia of mesenteric veins. Gastroenterol Hepatol 2012;8:696–700.
16. Thomas BS. Myointimal hyperplasia of the mesenteric veins mimicking infectious colitis. Int J Colorectal Dis 2013;28:727.
17. Lanitis S, Kontovounisios C, Karaliotas C. An extremely rare small bowel lesion associated with refractory ascites. Idiopathic myointimal hyperplasia of mesenteric veins of the small bowel associated with appendiceal mucocoele and pseudomyxoma peritonei. Gastroenterology 2012;142:e5–7.
18. Wangensteen KJ, Fogt F, Kann BR et al. Idiopathic Myointimal Hyperplasia of the Mesenteric Veins Diagnosed Preoperatively. J Clin Gastroenterol 2015;49:491-4.
19. Sahara K, Yamada R, Fujiwara T et al. Idiopathic myointimal hyperplasia of mesenteric veins: Rare case of ischemic colitis mimicking inflammatory bowel disease. Dig Endosc. 2015 Mar 16. doi: 10.1111/den.12470.
20. Abbott S, Hewett P, Cooper J et al. Idiopathic myointimal hyperplasia of the mesenteric veins: a rare differential to be considered in idiopathic colitis. ANZ J Surg. 2015 Jul 3. doi: 10.1111/ans.13210.
21. Laskaratos F-M, Hamilton M, Novelli M et al. A rare cause of abdominal pain, diarrhoea and GI bleeding. Gut. 2015;64:214.
22. Zijlstra M, Tjhie-Wensing JW, van Dijk M et al. [Idiopathic myointimal hyperplasia of mesenteric veins: an unusual cause of diarrhoea]. Ned Tijdschr Geneeskd. 2014;158:A7752.
Instrucciones para citar
Costa M, Saiote J, Pinheiro M, Duarte P, Bentes T, Ferraz Oliveira M, et all. Segmental colitis caused by idiopathic myointimal hyperplasia of mesenteric veins. 4051/2015


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Ficha Técnica

Recibido: 15/10/2015

Aceptado: 28/10/2015

Prepublicado: 22/02/2016

Publicado: 30/11/2016

Tiempo de revisión del artículo: 4 días

Tiempo de prepublicación: 130 días

Tiempo de edición del artículo: 412 días


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